Abstract

Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of
morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend
into adulthood, are interrelated, and are preventable.

Reporting Period Covered: January--December 2007.

Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories
of priority health-risk behaviors among youth and young adults, including behaviors that contribute
to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that
contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency
virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity. In addition, YRBSS monitors
the prevalence of obesity and asthma. YRBSS includes a national school-based survey conducted by CDC and
state and local school-based surveys conducted by state and local education and health agencies. This
report summarizes results from the national survey, 39 state surveys, and 22 local surveys conducted among
students in grades 9--12 during 2007.

Results: In the United States, 72% of all deaths among persons aged 10--24 years result from four
causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2007
national Youth Risk Behavior Survey (YRBS) indicated that many high school students engaged in behaviors
that increased their likelihood of death from these four causes. Among high school students nationwide
during 2007, 11.1% had never or rarely worn a seat belt when riding in a car driven by someone else. During the
30 days before the survey, 29.1% of high school students had ridden in a car or other vehicle driven by
someone who had been drinking alcohol, 18.0% had carried a weapon, and 5.5% had not gone to school because
they felt they would be unsafe at school or on their way to or from school. During the 12 months before the
survey, 6.9% of high school students had attempted suicide. In addition, 75.0% of high school students had
ever drunk alcohol, and 4.4% had ever used methamphetamines. Substantial morbidity and social problems
among youth also result from unintended pregnancies and STDs, including HIV infection. Results from the
2007 survey indicated that 47.8% of students had ever had sexual intercourse, 35.0% of high school students
were currently sexually active, and 38.5% of currently sexually active high school students had not used a
condom during last sexual intercourse. Among U.S. adults aged
>25 years, 59% of all deaths result from
twocauses: cardiovascular disease and cancer. Results from the 2007 national YRBS indicated that risk
behaviors associated with these two causes of death were present during adolescence. Among high school
students nationwide during 2007, 20.0% had smoked cigarettes during the 30 days before the survey, 35.4%
had watched television 3 or more hours per day on an average school day, and 13.0% were obese. During the
7 days before the survey, 78.6% of high school students had not eaten fruits and vegetables five or more
times per day, 33.8% had drunk soda or pop at least one time per day, and 65.3% had not met recommended
levels of physical activity.

Interpretation: Since 1991, the prevalence of many health-risk behaviors among high school
students nationwide has decreased. However, many high school students continue to engage in behaviors that
place
them at risk for the leading causes of mortality and morbidity. The prevalence of most risk behaviors does
not vary substantially among cities and states.

Public Health Action: YRBS data are used to measure progress toward achieving 15 national health
objectives for Healthy People 2010 and three of the 10 leading health indicators, to assess trends in priority
health-risk behaviors among high school students, and to evaluate the impact of broad school and
community interventions at the national, state, and local levels. More effective school health programs and other policy
and programmatic interventions are needed to reduce risk and improve health
outcomes among youth.

Introduction

In the United States, 72% of all deaths among youth and young adults aged 10--24 years result from four
causes: motor-vehicle crashes (30%), other unintentional injuries (15%), homicide (15%), and suicide (12%)
(1). Substantial morbidity and social problems also result from the
approximately 757,000 pregnancies among women aged
15--19 years (2), the estimated 9.1 million cases of sexually transmitted diseases (STDs) among persons aged 15--24 years
(3), and the estimated 5,089 cases of human immunodeficiency virus/acquired immunodeficiency syndrome
(HIV/AIDS) among persons aged 15--24 years
(4) that occur annually. Among adults aged
>25 years, 59% of all deaths in the United States result from cardiovascular disease (36%) and cancer (23%)
(1). These leading causes of morbidity and mortality among youth and adults in the United States are related to six categories of priority health-risk
behaviors: behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use;
sexual behaviors that contribute to unintended pregnancy and STDs, including HIV infection; unhealthy dietary
behaviors; and physical inactivity. These behaviors frequently are interrelated and are established during childhood and
adolescence and extend into adulthood.

To monitor priority health-risk behaviors in each of these six categories and obesity and asthma among youth
and young adults, CDC developed the Youth Risk Behavior Surveillance System (YRBSS)
(5). YRBSS includes national, state, and local school-based surveys of students in grades 9--12. National, state, and local surveys have
been conducted biennially since 1991 (Box).

This report summarizes results from the 2007 national Youth Risk Behavior Survey (YRBS) and trends during
1991--2007 in selected risk behaviors. Data from the 39 state and
22local surveys with weighted data for the 2007
YRBSS cycle also are included (Figure 1) in this report. Data from the remaining five state surveys with unweighted data are
not included. The national survey, 37weighted state surveys,
and22 weighted local surveys were conducted during
spring 2007, and two of the weighted state surveys were conducted during fall
2007.

Methods

Detailed information about the local, state, and national YRBSs has been described elsewhere
(5). Information also is available at
http://www.cdc.gov/yrbs.

Sampling

National Youth Risk Behavior Survey

The sampling frame for the 2007 national YRBS consisted of all public and private schools with students in at
least one of grades 9--12 in the 50 states and the District of Columbia. The sampling frame was obtained from the
Quality Education Data (QED), Inc., database
(6). The QED database includes information on both public and private
schools and the most recent data from the Common Core of Data from the National Center for Education Statistics
(7). A three-stage cluster sample design produced a nationally representative sample of students in grades 9--12 who
attend public and private schools. The first-stage sampling frame consisted of 1,268 primary sampling units (PSUs),
consisting of counties, subareas of large counties, or groups of smaller, adjacent counties.
The1,268PSUs were categorized into
16 strata according to their metropolitan statistical area (MSA) status (i.e., urbanicity) and the percentages of
black* and
Hispanic students in the PSUs. From the 1,268 PSUs, 57 were selected with probability proportional to overall
school enrollment size for the PSU.

In the second stage of sampling, 195 schools with any of grades 9--12 were selected with probability proportional
to school enrollment size. The third stage of sampling consisted of randomly selecting, in each chosen school and in each
of grades 9--12, one or two classrooms from either a required subject (e.g., English or social studies) or a
required period (e.g., homeroom or second period). All students in selected classes were eligible to participate. Schools, classes,
and students that refused to participate were not replaced.

To enable a separate analysis of data for black and Hispanic students, three strategies were used to oversample
these students: 1) larger sampling rates were used to select PSUs that are in high-black and high-Hispanic strata; 2)
a modified measure of size was used that increased the probability of selecting schools with a disproportionately
high minority enrollment; and 3) two classes per grade, rather than one, were selected in schools with a high
minority enrollment.

State and Local Youth Risk Behavior Surveys

In 2007, each state and local school-based survey
used a two-stage cluster sample design to produce a
representative sample of public school students in grades 9--12 in their jurisdiction. In the first sampling stage, schools with any
of grades 9--12 were selected with probability proportional to school enrollment size in 37 states and five cities; all
schools with any of grades 9--12 were selected in two states and 17 cities. In the second sampling stage, intact classes
from either a required subject (e.g., English or social
studies) or a required period (e.g., homeroom or second period)
were selected randomly, and all students in selected classes were eligible to participate in 38 states and 22 cities; all
students in selected schools were eligible to participate in one state.

Data Collection Procedures and Questionnaires

Survey procedures for the national, state, and local surveys were designed to protect students' privacy by allowing
for anonymous and voluntary participation. Before survey administration, local parental permission procedures
were followed. Students completed the self-administered questionnaire during one class period and recorded their
responses directly on a computer-scannable booklet or
answer sheet. CDC's Institutional Review Board approved the protocol
for the national YRBS.

The core questionnaire contained 87 questions. States and cities could add or delete questions from the
core questionnaire. For the national questionnaire, 11 questions were added to the core questionnaire. Skip patterns were
not included in any YRBS questionnaire to protect students' privacy by ensuring all students took about the same amount
of time to complete the survey. For state and local surveys, only data from core questions are presented in this
report. Information about the reliability of the core questionnaire has been published elsewhere
(8).

Data Processing Procedures and Response Rates

For the 2007 national YRBS, 14,103 questionnaires were completed in
157schools. The national data set was
cleaned and edited for inconsistencies. Missing data were not statistically imputed. Of the 14,103 completed
questionnaires from the national YRBS, 62 failed quality
control§ and were excluded from analysis, leaving
14,041usable questionnaires (Table 1). The school response rate was 81%; the student response rate was 84%; the overall response
rate was 68%¶ (Table 1).

In 2007, a total of 39 state and 22 local surveys had weighted data. Data from each state and local data set
were cleaned and edited for inconsistencies with the same procedures used for the national data set. The number of
completed questionnaires that failed quality control checks and were excluded from analysis from the state and local surveys
ranged from 0 to 117 (median: six). The student sample sizes ranged from 1,118 to 13,439 (Table 1). School
response rates ranged from 69% to 100%; student response rates ranged from 60% to 92%; and overall response rates ranged
from 60% to 90%.

Race/ethnicity was computed from two questions: 1) "Are you Hispanic or Latino?" (response options were "yes"
or "no"), and 2) "What is your race?" (response options were "American Indian or Alaska Native," "Asian," "black
or
African American," "Native Hawaiian or other Pacific
Islander," or "white"). For the second question, students
could select more than one response option. For this
report, students were classified as "Hispanic/Latino" if they
answered "yes" to the first question, regardless of how they answered the second question. Students were classified as "black" if
they answered "no" to the first question and
selected only "black or African American" to the second question. Students
were classified as "white" if they answered "no" to the first question and selected only "white" to the second
question. Students were classified as "other" if they answered "no" to the first question and selected "American Indian or
Alaska Native," "Asian," and/or "Native Hawaiian or other Pacific Islander" or selected more than one
response to the second question. Race/ethnicity was classified as missing for students who did not answer the first question and for
students who answered "no" to the first question but did not answer the second question. Throughout this report, students
who self-identified as "Hispanic/Latino" are referred to as "Hispanic" and students who self-identified as "black or
African American" are referred to as "black."

Students were classified as obese or overweight based on their body mass index
(kg/m2) (BMI), which was calculated from self-reported height and weight. The BMI values were compared with sex- and age-specific reference data from
the 2000 CDC growth charts (9). Obese was defined as a BMI of
>95th percentile for age and sex. Overweight was
defined as a BMI of >85th percentile and <95th percentile for age and sex. Previous YRBS reports used the terms
"overweight" to describe youth with a BMI
>95th percentile for age and sex and "at risk for overweight" for those with a BMI
>85th percentile and <95th percentile. However, this report uses the terms "obese" and "overweight" in accordance with
the 2007 recommendations from the Expert Committee on the Assessment, Prevention, and Treatment of Child
and Adolescent Overweight and Obesity convened by the American Medical Association (AMA) and cofunded by AMA
in collaboration with the Health Resources and Services Administration and CDC
(10). These classifications are not intended to diagnose obesity or overweight in individual students, rather to provide
estimates of obesity and overweight for the population of students surveyed.

Weighting

For the national YRBS, a weight based on student sex, race/ethnicity, and grade was applied to each record
to adjust for school and student nonresponse and oversampling of black and Hispanic students. The overall weights
were scaled so that the weighted count of students equals the total sample size, and the weighted proportions of students
in each grade match the national population proportions. Therefore, weighted estimates are representative of all students
in grades 9--12 attending public and private school in the United States.

State and local surveys that had a representative sample of students, appropriate documentation, and an
overall response rate of 60% or higher were weighted. A weight was applied to each record to adjust for student
nonresponse and the distribution of students by grade, sex, and race/ethnicity in each jurisdiction. Therefore, weighted state
and local estimates are representative of all students
in grades 9--12 attending public schools in each jurisdiction.

Analytic Methods

Statistical analyses were conducted on weighted data
using SAS® (11) and SUDAAN
(12) software to account for the complex sampling designs. Prevalence estimates and confidence intervals were computed for all variables and all
data sets. In addition, for the national YRBS data, t tests were used to determine pairwise differences between
subpopulations and temporal changes during 2005--2007
(13). Differences between prevalence estimates were considered
statistically significant if the t test p value was <0.05 for main effects (sex, race/ethnicity, and grade), for interactions (sex by
race/ethnicity, sex by grade, race/ethnicity by sex, and grade by sex), and for changes over time. Only statistically
significant differences in prevalence estimates are reported in the results section in the following order: sex, sex by race/ethnicity,
sex by grade, race/ethnicity, race/ethnicity by sex, grade, and grade by sex.

For the national YRBS data, temporal changes from the earliest year of data collection to 2007 were analyzed
using logistic regression analyses that controlled for sex, grade, and race/ethnicity and that simultaneously assessed linear
and quadratic time effects (13). Quadratic trends indicate a significant but nonlinear trend in the data over time. Trends
that
include significant linear and quadratic components demonstrate nonlinear variation (e.g., leveling off or change
in direction) in addition to an overall increase or decrease over time. Trends are described only for variables with
significant temporal changes from the earliest year of data collection to 2007 or during 2005--2007.

Results

Behaviors that Contribute to Unintentional Injuries

Seat Belt Use

Nationwide, 11.1% of students had rarely or never worn a seat belt when riding in a car driven by someone else
(Table 2). Overall, the prevalence of having rarely or never worn a seat belt was higher among male (13.6%)
than female (8.5%) students; higher among white male (13.0%), black male (14.7%), and Hispanic male (14.3%)
than white female (7.3%), black female (10.0%), and Hispanic female (11.4%) students, respectively; and higher
among 9th-grade male (15.1%), 10th-grade male (13.2%), 11th-grade male (12.2%), and 12th-grade male (13.8%) than
9th-grade female (9.2%), 10th-grade female (8.3%), 11th-grade female (8.9%), and 12th-grade female (7.3%)
students, respectively. Prevalence of having rarely or never worn a seat belt ranged from 6.0% to 19.4% across state
surveys (median: 11.2%) and from 5.6% to 25.1% across local surveys (median: 9.6%) (Table 3).

Bicycle Helmet Use

Among the 66.8% of students nationwide who had ridden a bicycle during the 12 months before the survey,
85.1% had rarely or never worn a bicycle helmet (Table 2). Overall, the prevalence of having rarely or never worn a
bicycle helmet was higher among male (87.4%) than female
(82.2%) students; higher among white male (85.6%) than
white female (79.5%) students; and higher among 9th-grade male (86.4%), 10th-grade male (88.1%), and 11th-grade
male (88.1%) than 9th-grade female (80.1%), 10th-grade female (83.0%), and 11th-grade
female (83.0%) students, respectively. Overall, the prevalence of having rarely or never worn a bicycle helmet was higher among black
(94.2%) and Hispanic (88.7%) than white (82.9%) students; higher among black (94.2%) than Hispanic (88.7%)
students; higher among black female (93.0%) and Hispanic female (86.6%) than white female (79.5%) students; higher
among black female (93.0%) than Hispanic female (86.6%) students; higher among black male (95.0%) and Hispanic
male (90.3%) than white male (85.6%) students; and higher among black male (95.0%) than Hispanic male
(90.3%) students. Prevalence of having rarely or never worn a bicycle helmet among students who had ridden a bicycle
during the 12 months before the survey ranged from 57.6% to 94.8% across state surveys (median: 87.8%) and from 69.7%
to 96.4% across local surveys (median: 88.8%) (Table 3).

Motorcycle Helmet Use

Among the 24.3% of students nationwide who had ridden a motorcycle during the 12 months before the
survey, 33.9% had rarely or never worn a motorcycle helmet
(Table 4). Overall, the prevalence of having rarely or never worn
a motorcycle helmet was higher among male (38.1%) than female (27.1%) students; higher among white male
(30.8%) and black male (52.4%) than white female (19.2%) and black female (36.0%) students, respectively; and higher
among 9th-grade male (41.4%), 11th-grade male (38.1%), and 12th-grade male (36.5%) than 9th-grade female
(29.8%), 11th-grade female (24.9%), and 12th-grade female (24.8%) students, respectively. Overall, the prevalence of
having rarely or never worn a motorcycle helmet was higher among black (46.0%) and Hispanic (51.3%) than white
(26.3%) students; higher among black female (36.0%) and Hispanic female (49.6%) than white female (19.2%) students;
and higher among black male (52.4%) and Hispanic male (52.4%) than white male (30.8%) students.

Rode with a Driver Who Had Been Drinking Alcohol

During the 30 days before the survey, 29.1% of students nationwide had ridden one or more times in a car or
other vehicle driven by someone who had been drinking alcohol (Table 5). The prevalence of having ridden with a driver
who had been drinking alcohol was higher among 11th-grade male (31.4%) than 11th-grade female (26.8%)
students. Overall, the prevalence of having ridden with a driver who had been drinking alcohol was higher among
Hispanic
(35.5%) than white (27.9%) and black (27.4%) students; higher among Hispanic female (35.1%) than white
female (28.0%) and black female (26.9%) students; and higher among Hispanic male (36.0%) than white male (27.8%)
and black male (28.1%) students. Overall, the prevalence of having ridden with a driver who had been drinking alcohol
was higher among 12th-grade (31.5%) than 9th-grade (27.6%) students and higher among 11th-grade male (31.4%)
and 12th-grade male (32.5%) than 10th-grade male (27.1%) students. The prevalence of having ridden with a driver
who had been drinking alcohol ranged from 14.8% to 35.6% across state surveys (median: 27.4%) and from 18.0%
to 38.4% across local surveys (median: 27.0%) (Table 6).

Drove When Drinking Alcohol

During the 30 days before the survey, 10.5% of students nationwide had driven a car or other vehicle one or
more times when they had been drinking alcohol(Table 5). Overall, the prevalence of having driven when they had
been drinking alcohol was higher among male (12.8%) than female (8.1%) students; higher among white male
(13.9%), black male (7.5%), and Hispanic male (13.0%) than white female (9.3%), black female (3.9%), and Hispanic
female (7.7%) students, respectively; and higher among 9th-grade male (6.8%), 11th-grade male (13.7%), and
12th-grade male (23.6%) than 9th-grade female (4.1%), 11th-grade female (9.1%), and 12th-grade female (13.1%)
students, respectively. Overall, the prevalence of having driven when they had been drinking alcohol was higher among
white (11.6%) and Hispanic (10.3%) than black (5.7%) students; higher among white female (9.3%) and Hispanic
female (7.7%) than black female (3.9%) students; and higher among white male (13.9%) and Hispanic male (13.0%)
than black male (7.5%) students. Overall, the prevalence of having driven when they had been drinking alcohol was
higher among 10th-grade (8.7%), 11th-grade (11.5%), and 12th-grade (18.3%) than 9th-grade (5.5%) students;
higher among 11th-grade (11.5%) and 12th-grade (18.3%) than 10th-grade (8.7%) students; higher among
12th-grade (18.3%) than 11th-grade (11.5%) students; higher among 10th-grade female (7.3%), 11th-grade female (9.1%),
and 12th-grade female (13.1%) than 9th-grade female (4.1%) students; higher among 12th-grade female (13.1%)
than 10th-grade female (7.3%) and 11th-grade female (9.1%) students; higher among 10th-grade male (10.0%),
11th-grade male (13.7%), and 12th-grade male (23.6%) than 9th-grade male (6.8%) students; higher among 11th-grade
male (13.7%) and 12th-grade male (23.6%) than 10th-grade male (10.0%) students; and higher among 12th-grade
male (23.6%) than 11th-grade male (13.7%) students. The prevalence of having driven a car when they had been
drinking alcohol ranged from 4.7% to 18.7% across state surveys (median: 10.4%) and from 2.8% to 12.9% across local
surveys (median: 6.6%) (Table 6).

Behaviors that Contribute to Violence

Carried a Weapon

Nationwide, 18.0% of students had carried a weapon (e.g., a gun, knife, or club) on at least 1 day during the 30
days before the survey (Table 7). Overall, the prevalence of having carried a weapon was higher among male (28.5%)
than female (7.5%) students; higher among white male (30.3%), black male (24.6%), and Hispanic male (28.2%)
than white female (6.1%), black female (10.0%), and Hispanic female (9.0%) students, respectively; and higher among
9th-grade male (31.0%), 10th-grade male (29.3%), 11th-grade male (27.7%), and 12th-grade male (25.0%) than
9th-grade female (8.9%), 10th-grade female (8.1%), 11th-grade female (6.0%), and 12th-grade female (6.2%)
students, respectively. The prevalence of having carried a weapon was higher among black female (10.0%) and Hispanic
female (9.0%) than white female (6.1%) students; and higher among white male (30.3%) than black male (24.6%)
students. Overall, the prevalence of having carried a weapon was higher among 9th-grade (20.1%) than 11th-grade (16.7%)
and 12th-grade (15.5%) students; higher among 10th-grade (18.8%) than 12th-grade (15.5%) students; higher
among 9th-grade female (8.9%) than 11th-grade female (6.0%) and 12th-grade female (6.2%) students; and higher
among 9th-grade male (31.0%) and 10th-grade male (29.3%) than 12th-grade male (25.0%) students. The prevalence
of having carried a weapon ranged from 12.0% to 27.5% across state surveys (median: 18.5%) and from 8.6% to
21.7% across local surveys (median: 16.3%) (Table 8).

Carried a Gun

Nationwide, 5.2% of students had carried a gun on at least 1 day during the 30 days before the survey (Table 7). Overall, the prevalence of having carried a gun was higher among male (9.0%) than female (1.2%) students;
higher among white male (7.8%), black male (11.2%), and Hispanic male (10.4%) than white female (0.8%),
black female (1.3%), and Hispanic female (2.1%) students,
respectively; and higher among 9th-grade male (8.9%),
10th-grade male (9.8%), 11th-grade male (8.1%), and 12th-grade male (9.2%) than 9th-grade female (1.4%),
10th-grade female (1.1%), 11th-grade female (1.2%), and 12th-grade female (0.9%) students, respectively. Overall, the
prevalence of having carried a gun was higher among black (6.2%) and Hispanic (6.2%) than white (4.3%) students;
higher among Hispanic female (2.1%) than white female (0.8%) students; and higher among black male (11.2%)
and Hispanic male (10.4%) than white male (7.8%) students. Prevalence of having carried a gun ranged from 3.5%
to 11.7% across state surveys (median: 6.5%) and from 2.1% to 8.9% across local surveys (median: 5.5%) (Table 8).

In a Physical Fight

Nationwide, 35.5% of students had been in a physical fight one or more times during the 12 months before
the survey (Table 9). Overall, the prevalence of having been in a physical fight was higher among male (44.4%)
than female (26.5%) students; higher among white male (41.9%), black male (50.3%), and Hispanic male (47.3%)
than white female (21.5%), black female (39.4%), and Hispanic female (33.5%) students, respectively; and higher
among 9th-grade male (49.6%), 10th-grade male (45.1%), 11th-grade male (46.3%), and 12th-grade male (34.3%) than
9th-grade female (31.8%), 10th-grade female (27.2%), 11th-grade female (23.5%), and 12th-grade
female (21.8%) students, respectively. Overall, the prevalence of having been in a physical fight was higher among black (44.7%)
and Hispanic (40.4%) than white (31.7%) students; higher among black (44.7%) than Hispanic (40.4%) students;
higher among black female (39.4%) and Hispanic female (33.5%) than white female (21.5%) students; higher among
black female (39.4%) than Hispanic female (33.5%) students; and higher among black male (50.3%) and Hispanic
male (47.3%) than white male (41.9%) students. Overall, the prevalence of having been in a physical fight was higher
among 9th-grade (40.9%) than 10th-grade (36.2%), 11th-grade (34.8%), and 12th-grade (28.0%) students; higher
among 10th-grade (36.2%) and 11th-grade (34.8%) than 12th-grade (28.0%) students; higher among 9th-grade
female (31.8%) than 10th-grade female (27.2%), 11th-grade female (23.5%), and 12th-grade female (21.8%)
students; higher among 10th-grade female (27.2%) than 11th-grade female (23.5%) and 12th-grade female (21.8%)
students; and higher among 9th-grade male (49.6%), 10th-grade male (45.1%), and 11th-grade male (46.3%) than
12th-grade male (34.3%) students. Prevalence of having been in a physical fight ranged from 24.0% to 37.1% across state
surveys (median: 30.3%) and from 22.8% to 45.0% across local surveys (median: 33.6%) (Table 10).

Injured in a Physical Fight

Nationwide, 4.2% of students had been in a physical fight one or more times during the 12 months before the
survey in which they were injured and had to be treated by a doctor or nurse (Table 9). Overall, the prevalence of having
been injured in a physical fight was higher among male (5.5%) than female (2.9%) students; higher among white
male (4.1%) and Hispanic male (7.6%) than white female (2.0%) and Hispanic female (5.1%) students, respectively;
and higher among 9th-grade male (6.7%), 10th-grade male (5.4%), 11th-grade male (4.6%), and 12th-grade male
(4.4%) than 9th-grade female (4.3%), 10th-grade female (2.1%), 11th-grade female (2.5%), and 12th-grade female
(2.3%) students, respectively. Overall, the prevalence of having been injured in a physical fight was higher among black
(5.3%) and Hispanic (6.3%) than white (3.0%) students; higher among black female (4.2%) and Hispanic female (5.1%)
than white female (2.0%) students; and higher among black male (6.5%) and Hispanic male (7.6%) than white male
(4.1%) students. Overall, the prevalence of having been injured in a physical fight was higher among 9th-grade (5.6%)
than 10th-grade (3.7%), 11th-grade (3.5%), and 12th-grade (3.3%) students; higher among 9th-grade female (4.3%)
than 10th-grade female (2.1%), 11th-grade female (2.5%), and 12th-grade female (2.3%) students; and higher among
9th-grade male (6.7%) than 11th-grade male (4.6%) and 12th-grade male (4.4%) students. The prevalence of having
been injured in a physical fight ranged from 2.2% to 6.0% across state surveys
(median: 3.8%) and from 3.3% to 9.6% across local surveys
(median: 4.6%) (Table 10).

Dating Violence

During the 12 months before the survey, 9.9% of students nationwide had been hit, slapped, or physically hurt
on purpose by their boyfriend or girlfriend (i.e., dating violence) (Table 11). Overall, the prevalence of dating violence
was higher among male (11.0%) than female (8.8%) students and higher among 9th-grade male (10.5%) and
12th-grade male (14.1%) than 9th-grade female (6.3%) and 12th-grade female (10.1%) students, respectively. Overall,
the prevalence of dating violence was higher among black (14.2%) and Hispanic (11.1%) than white (8.4%)
students; higher among black (14.2%) than Hispanic (11.1%) students; higher among black female (13.2%) and
Hispanic female (10.1%) than white female (7.4%) students; higher among black female (13.2%) than Hispanic female
(10.1%) students; and higher among black male (15.2%) than white male (9.3%) students. Overall, the prevalence of
dating violence was higher among 11th-grade (10.6%) and 12th-grade (12.1%) than 9th-grade (8.5%) and
10th-grade (8.9%) students; higher among 11th-grade female (10.2%) and 12th-grade female (10.1%) than 9th-grade
female (6.3%) students; and higher among 12th-grade male (14.1%) than 9th-grade male (10.5%) and 10th-grade
male (9.1%) students. Prevalence of dating violence ranged from 7.2% to 15.7% across state surveys (median: 11.8%)
and from 6.6% to 17.4% across local surveys (median: 12.0%) (Table 12).

Forced to Have Sexual Intercourse

Nationwide, 7.8% of students had ever been physically forced to have sexual intercourse when they did not want
to (Table 11). Overall, the prevalence of having been forced to have sexual intercourse was higher among female
(11.3%) than male (4.5%) students; higher among white female (11.0%), black female (13.3%), and Hispanic female
(11.4%) than white male (3.2%), black male (7.8%), and Hispanic male (6.2%) students, respectively; and higher among
9th-grade female (9.2%), 10th-grade female (13.1%), 11th-grade female (12.0%), and 12th-grade
female (10.9%) than 9th-grade male (4.1%), 10th-grade male (3.4%), 11th-grade male (5.0%), and 12th-grade male (5.7%)
students, respectively. Overall, the prevalence of having been forced to have sexual intercourse was higher among black
(10.5%) and Hispanic (8.8%) than white (7.0%) students and higher among black male (7.8%) and Hispanic male (6.2%)
than white male (3.2%) students. Overall, the prevalence of having been forced to have sexual intercourse was higher
among 11th-grade (8.5%) and 12th-grade (8.3%) than 9th-grade (6.6%) students; higher among 10th-grade female
(13.1%) than 9th-grade female (9.2%) students; and higher among 11th-grade male (5.0%) and 12th-grade male (5.7%)
than 10th-grade male (3.4%) students. Prevalence of having been forced to have sexual intercourse ranged from 6.3%
to 14.0% across state surveys (median: 9.1%) and from 5.6% to 12.2% across local surveys (median: 8.5%) (Table 12).

Carried a Weapon on School Property

Nationwide, 5.9% of students had carried a weapon (e.g., a gun, knife, or club) on school property on at least 1
day during the 30 days before the survey (Table 13). Overall, the prevalence of having carried a weapon on school
property was higher among male (9.0%) than female (2.7%) students; higher among white male (8.5%), black male (8.4%),
and Hispanic male (10.4%) than white female (2.1%), black female (3.5%), and Hispanic female (4.1%)
students, respectively; and higher among 9th-grade male (8.7%), 10th-grade male (8.8%), 11th-grade male (8.6%), and
12th-grade male (9.8%) than 9th-grade female (3.1%), 10th-grade female (2.6%), 11th-grade female (2.4%), and
12th-grade female (2.3%) students, respectively. The prevalence of having carried a weapon on school property was
higher among black female (3.5%) and Hispanic female (4.1%) than white female (2.1%) students. Prevalence of
having carried a weapon on school property ranged from 3.6% to 11.4% across state surveys (median: 5.6%) and from 2.6%
to 9.9% across local surveys (median: 5.2%) (Table 14).

Threatened or Injured with a Weapon on School Property

During the 12 months before the survey, 7.8% of students nationwide had been threatened or injured with a
weapon (e.g., a gun, knife, or club) on school property one or more times (Table 13). Overall, the prevalence of having
been threatened or injured with a weapon on school property was higher among male (10.2%) than female (5.4%)
students; higher among white male (9.2%), black male (11.2%), and Hispanic male (12.0%) than white female (4.6%),
black female (8.1%), and Hispanic female (5.4%) students, respectively; and higher among 9th-grade male (11.4%),
10th-grade male (10.4%), 11th-grade male (10.5%), and 12th-grade male (8.1%) than 9th-grade
female (6.8%), 10th-grade female (6.3%), 11th-grade
female (3.2%), and 12th-grade female (4.5%) students, respectively. Overall, the
prevalence
of having been threatened or injured with a weapon on school property was higher among black (9.7%) and
Hispanic (8.7%) than white (6.9%) students; higher among black female (8.1%) than white female (4.6%) and Hispanic
female (5.4%) students; and higher among Hispanic male (12.0%) than white male (9.2%) students. Overall, the
prevalence of having been threatened or injured with a weapon on school property was higher among 9th-grade (9.2%) and
10th-grade (8.4%) than 11th-grade (6.8%) and 12th-grade (6.3%) students; higher among 9th-grade female (6.8%)
and 10th-grade female (6.3%) than 11th-grade female (3.2%) students; and higher among 9th-grade male (11.4%)
and 11th-grade male (10.5%) than 12th-grade male (8.1%) students. Prevalence of having been threatened or injured
with a weapon on school property ranged from 5.2% to 11.4% across state surveys (median: 8.1%) and from 5.8% to
12.8% across local surveys (median: 9.1%) (Table 14).

In a Physical Fight on School Property

Nationwide, 12.4% of students had been in a physical fight on school property one or more times during the
12 months before the survey (Table 15). Overall, the prevalence of having been in a physical fight on school property
was higher among male (16.3%) than female (8.5%) students; higher among white male (14.5%), black male (20.0%),
and Hispanic male (18.5%) than white female (5.9%), black female (15.2%), and Hispanic female (12.4%)
students, respectively; and higher among 9th-grade male (22.3%), 10th-grade male (15.0%), 11th-grade male (14.8%),
and 12th-grade male (11.1%) than 9th-grade female (11.4%), 10th-grade female (8.3%), 11th-grade female (7.3%),
and 12th-grade female (6.2%) students, respectively. Overall, the prevalence of having been in a physical fight on
school property was higher among black (17.6%) and Hispanic (15.5%) than white (10.2%) students; higher among
black female (15.2%) and Hispanic female (12.4%) than white female (5.9%) students; and higher among black
male (20.0%) and Hispanic male (18.5%) than white male (14.5%) students. Overall, the prevalence of having been in
a physical fight on school property was higher among 9th-grade (17.0%) than 10th-grade (11.7%), 11th-grade
(11.0%), and 12th-grade (8.6%) students; higher among 10th-grade (11.7%) and 11th-grade (11.0%) than 12th-grade
(8.6%) students; higher among 9th-grade female (11.4%) than 10th-grade female (8.3%), 11th-grade female (7.3%),
and 12th-grade female (6.2%) students; higher among 9th-grade male (22.3%) than 10th-grade male (15.0%),
11th-grade male (14.8%), and 12th-grade male (11.1%) students; and higher among 10th-grade male (15.0%) and
11th-grade male (14.8%) than 12th-grade male (11.1%) students. Prevalence of having been in a physical fight on school
property ranged from 7.0% to 16.9% across state surveys
(median: 11.3%) and from 8.1% to 21.2% across local
surveys (median: 14.5%) (Table 16).

Had Property Stolen or Damaged on School Property

Nationwide, 27.1% of students had had their property (e.g., car, clothing, or books) stolen or deliberately
damaged on school property one or more times during the 12 months before the survey (Table 15). Overall, the prevalence
of having property stolen or damaged on school property was higher among male (30.4%) than female (23.7%)
students; higher among white male (29.3%), black male (32.8%), and Hispanic male (32.0%) than white female (22.6%),
black female (25.6%), and Hispanic female (26.0%) students, respectively; and higher among 11th-grade male (32.1%)
and 12th-grade male (27.2%) than 11th-grade female (19.7%) and 12th-grade female (18.8%) students,
respectively. Overall, the prevalence of having property stolen or damaged on school property was higher among black (29.3%)
and Hispanic (29.0%) than white (25.9%) students. Overall, the prevalence of having property stolen or damaged on
school property was higher among 9th-grade (30.6%) than 11th-grade (25.9%) and 12th-grade (22.9%) students;
higher among 10th-grade (27.6%) than 12th-grade (22.9%) students; higher among 9th-grade female (28.8%) and
10th-grade female (25.8%) than 11th-grade female (19.7%) and 12th-grade female (18.8%) students; and higher
among 9th-grade male (32.2%) than 12th-grade male (27.2%) students. Prevalence of having property stolen or
deliberately damaged on school property ranged from 19.8% to 34.0% across state surveys (median: 27.2%) and from 22.8%
to 36.6% across local surveys (median: 27.4%) (Table 16).

Did Not Go to School Because of Safety Concerns

Nationwide, 5.5% of students had not gone to school on at least 1 day during the 30 days before the survey
because they felt they would be unsafe at school or on their way to or from school (Table 17). Overall, the prevalence of
having not gone to school because of safety concerns was higher among black (6.6%) and Hispanic (9.6%) than white
(4.0%)
students; higher among Hispanic (9.6%) than black (6.6%) students; higher among black female (6.3%) and
Hispanic female (9.7%) than white female (4.2%) students; higher among Hispanic female (9.7%) than black female
(6.3%) students; higher among black male (6.8%) and Hispanic male (9.6%) than white male (3.7%) students; and
higher among Hispanic male (9.6%) than black male (6.8%) students. Overall, the prevalence of having not gone to
school because of safety concerns was higher among 9th-grade (6.6%) than 11th-grade (4.7%) and 12th-grade
(4.8%) students; and higher among 9th-grade female (7.4%) and 10th-grade female (6.0%) than 11th-grade female
(3.9%) and 12th-grade female (4.3%) students. Prevalence of having not gone to school because of safety concerns ranged
from 3.8% to 9.0% across state surveys (median: 5.8%) and from 5.4% to 14.4% across local
surveys (median: 9.1%) (Table 18).

Felt Sad or Hopeless

During the 12 months before the survey, 28.5% of students nationwide had felt so sad or hopeless almost every
day for 2 or more weeks in a row that they stopped doing some usual activities (Table 19). Overall, the prevalence of
having felt sad or hopeless almost every day for 2 or more weeks in a row was higher among female (35.8%) than male
(21.2%) students; higher among white female (34.6%), black female (34.5%), and Hispanic female (42.3%) than white
male (17.8%), black male (24.0%), and Hispanic male (30.4%) students, respectively; and higher among 9th-grade
female (34.8%), 10th-grade female (37.7%), 11th-grade female (34.5%), and 12th-grade female (35.9%) than 9th-grade
male (22.1%), 10th-grade male (20.3%), 11th-grade male (19.5%), and 12th-grade male (22.6%) students,
respectively. Overall, the prevalence of having felt sad or hopeless almost every day for 2 or more weeks in a row was higher
among black (29.2%) and Hispanic (36.3%) than white (26.2%) students; higher among Hispanic (36.3%) than
black (29.2%) students; higher among Hispanic female (42.3%) than white female (34.6%) and black female
(34.5%) students; higher among black male (24.0%) and Hispanic male (30.4%) than white male (17.8%) students; and
higher among Hispanic male (30.4%) than black male (24.0%) students. Prevalence of having felt sad or hopeless almost
every day for 2 or more weeks ranged from 17.1% to 32.5% across state surveys (median: 26.1%) and from 24.8% to
32.2% across local surveys (median: 27.8%) (Table 20).

Seriously Considered Attempting Suicide

Nationwide, 14.5% of students had seriously considered attempting suicide during the 12 months before the
survey (Table 21). Overall, the prevalence of having seriously considered attempting suicide was higher among female
(18.7%) than male (10.3%) students; higher among white female (17.8%), black female (18.0%), and Hispanic
female (21.1%) than white male (10.2%), black male (8.5%), and Hispanic male (10.7%) students, respectively; and higher
among 9th-grade female (19.0%), 10th-grade female (22.0%), 11th-grade female (16.3%), and
12th-grade female (16.7%) than 9th-grade male (10.8%), 10th-grade male (9.3%), 11th-grade male (10.7%), and 12th-grade male
(10.2%) students, respectively. The prevalence of having seriously considered attempting suicide was higher among
Hispanic female (21.1%) than white female (17.8%) students. The prevalence of having seriously considered attempting
suicide was higher among 10th-grade female (22.0%) than 11th-grade female (16.3%) and 12th-grade female
(16.7%) students. Prevalence of having
seriouslyconsidered attempting suicide ranged from 10.4% to 19.3% across state
surveys (median: 14.5%) and from 9.7% to 15.0% across local surveys (median: 12.7%)
(Table 22).

Made a Suicide Plan

During the 12 months before the survey, 11.3% of students nationwide had made a plan about how they
wouldattempt suicide (Table 21). Overall, the prevalence of having made a suicide plan was higher among female
(13.4%) than male (9.2%) students; higher among white female (12.8%), black female (12.0%), and Hispanic female
(15.2%) than white male (8.8%), black male (7.1%), and Hispanic male (10.4%) students, respectively; and higher among
9th-grade female (13.4%) and 10th-grade female (16.1%) than 9th-grade male (9.2%) and 10th-grade male
(8.9%) students, respectively. Overall, the prevalence of having made a suicide plan was higher among Hispanic (12.8%)
than white (10.8%) and black (9.5%) students; higher among Hispanic female (15.2%) than white female
(12.8%) students; and higher among Hispanic male (10.4%) than black male (7.1%) students, respectively. The prevalence
of having made a suicide plan was higher among 10th-grade female (16.1%) than 11th-grade female (11.6%) and
12th-
grade female (11.7%) students. Prevalence of having made a suicide plan ranged from 8.1% to 17.8% across
state surveys (median: 11.5%) and from 8.0% to 14.7% across local surveys (median: 10.9%) (Table 22).

Attempted Suicide

Nationwide, 6.9% of students had attempted suicide one or more times during the 12 months before the
survey (Table 23). Overall, the prevalence of having attempted suicide was higher among female (9.3%) than male
(4.6%) students; higher among white female (7.7%), black female (9.9%), and Hispanic female (14.0%) than white
male (3.4%), black male (5.5%), and Hispanic male (6.3%) students, respectively; and higher among 9th-grade
female (10.5%), 10th-grade female (11.2%), 11th-grade female (7.8%), and 12th-grade female (6.5%) than 9th-grade
male (5.3%), 10th-grade male (4.9%), 11th-grade male (3.7%), and 12th-grade male (4.2%) students, respectively.
Overall, the prevalence of having attempted suicide was higher among black (7.7%) and Hispanic (10.2%) than white
(5.6%) students; higher among Hispanic (10.2%) than black (7.7%) students; higher among Hispanic female (14.0%)
than white female (7.7%) and black female (9.9%) students; and higher among black male (5.5%) and Hispanic
male (6.3%) than white male (3.4%) students. Overall, the prevalence of having attempted suicide was higher among
9th-grade (7.9%) and 10th-grade (8.0%) than 11th-grade (5.8%) and 12th-grade (5.4%) students; higher among
9th-grade female (10.5%) than 12th-grade female (6.5%) students; and higher among 10th-grade
female (11.2%) than 11th-grade female (7.8%) and 12th-grade female (6.5%) students. Prevalence of having
attempted suicide ranged from 4.8% to 14.3% across state surveys (median: 7.9%) and from 5.1% to 13.3% across local surveys (median:
9.0%) (Table 24).

Suicide Attempt Treated by a Doctor or Nurse

During the 12 months before the survey, 2.0% of students nationwide had made a suicide attempt that resulted in
an injury, poisoning, or an overdose that had to be treated by a doctor or nurse (Table 23). Overall, the prevalence
of having made a suicide attempt that resulted in an injury, poisoning, or an overdose that had to be treated by a doctor
or nurse was higher among female (2.4%) than male (1.5%) students; higher among white female (2.1%) and
Hispanic female (3.9%) than white male (0.9%) and Hispanic male (1.8%) students, respectively; and higher among
10th-grade female (3.1%) than 10th-grade male (1.0%) students. Overall, the prevalence of having made a suicide attempt
that resulted in an injury, poisoning, or an overdose that had to be treated by a doctor or nurse was higher among
Hispanic (2.9%) than white (1.5%) students; higher among Hispanic female (3.9%) than white female (2.1%) and black
female (2.1%) students; and higher among black male (2.5%) and Hispanic male (1.8%) than white male (0.9%)
students. Overall, the prevalence of having made a suicide attempt that resulted in an
injury, poisoning, or an overdose that had to be treated by a doctor or nurse was higher among 9th-grade (2.3%) than 12th-grade (1.7%) students and
higher among 10th-grade female (3.1%) than 11th-grade female (1.7%) students. Prevalence of having made a suicide
attempt that resulted in an injury, poisoning, or an overdose that had to be treated by a doctor or nurse ranged from 1.5%
to 4.8% across state surveys (median: 2.6%) and from 1.4% to 4.7% across local surveys (median: 2.9%) (Table 24).

Tobacco Use

Lifetime Cigarette Use

Nationwide, 50.3% of students had ever tried cigarette smoking (even one or two puffs) (i.e., lifetime cigarette
use) (Table 25). Overall, the prevalence of lifetime cigarette use was higher among male (51.8%) than female
(48.8%) students; higher among white male (51.7%) than white
female (48.3%) students; and higher among 9th-grade
male (46.0%) than 9th-grade female (39.2%) students. Overall, the prevalence of lifetime cigarette use was higher
among 10th-grade (48.8%), 11th-grade (53.4%), and 12th-grade (59.3%) than 9th-grade (42.7%) students; higher
among 11th-grade (53.4%) and 12th-grade (59.3%) than 10th-grade (48.8%) students; and higher among
12th-grade (59.3%) than 11th-grade (53.4%) students. Overall, the prevalence of lifetime cigarette use was higher among
10th-grade female (48.7%), 11th-grade female (51.4%), and 12th-grade female (58.5%) students than 9th-grade
female (39.2%) students; higher among 12th-grade female (58.5%) than 10th-grade female (48.7%) and 11th-grade
female (51.4%) students; and higher among 11th-grade male (55.4%) and 12th-grade male (60.1%) than 9th-grade
male
(46.0%) and 10th-grade male (48.8%) students. Prevalence of lifetime cigarette use ranged from 24.9% to
62.2% across state surveys (median: 51.9%) and from 36.5% to 57.6% across local surveys (median: 43.6%) (Table 26).

Lifetime Daily Cigarette Use

Nationwide, 12.4% of students had ever smoked at least one cigarette every day for 30 days (i.e., lifetime
daily cigarette use) (Table 25). The prevalence of lifetime daily cigarette use was higher among black male (7.3%) than
black female (5.0%) students and higher among 9th-grade male (10.3%) than 9th-grade female (6.3%) students. Overall,
the prevalence of lifetime daily cigarette use was higher among white (15.4%) than black (6.2%) and Hispanic
(8.0%) students; higher among white female (14.9%) than black female (5.0%) and Hispanic female (7.1%) students;
and higher among white male (15.8%) than black male (7.3%) and Hispanic male (8.9%) students. Overall, the
prevalence of lifetime daily cigarette use was higher among 10th-grade (12.0%), 11th-grade (13.8%), and 12th-grade
(16.8%) than 9th-grade (8.3%) students; higher among 12th-grade (16.8%) than 10th-grade (12.0%) students; higher
among 10th-grade female (12.4%), 11th-grade female
(14.0%), and 12th-grade female (15.8%) than 9th-grade female
(6.3%) students; higher among 12th-grade female (15.8%) than 10th-grade female (12.4%) students; and higher among
12th-grade male (18.0%) than 9th-grade male (10.3%), 10th-grade male (11.7%), and 11th-grade male (13.4%)
students. Prevalence of lifetime daily cigarette use ranged from 4.6% to 21.1% across state surveys (median: 13.3%) and
from 4.0% to 9.1% across local surveys (median: 6.0%) (Table 26).

Current Cigarette Use

Nationwide, 20.0% of students had smoked cigarettes on at least 1 day during the 30 days before the survey
(i.e., current cigarette use) (Table 27). Overall, the prevalence of current cigarette use was higher among male (21.3%)
than female (18.7%) students and higher among black male (14.9%) and Hispanic male (18.7%) than black female
(8.4%) and Hispanic female (14.6%) students, respectively. Overall, the prevalence of current cigarette use was higher
among white (23.2%) than black (11.6%) and Hispanic (16.7%) students; higher among Hispanic (16.7%) than
black (11.6%) students; higher among white female (22.5%) than black female (8.4%) and Hispanic female
(14.6%) students; higher among Hispanic female (14.6%) than black female (8.4%) students; and higher among white
male (23.8%) than black male (14.9%) and Hispanic male (18.7%) students. Overall, the prevalence of current cigarette
use was higher among 10th-grade (19.6%), 11th-grade (21.6%), and 12th-grade (26.5%) than 9th-grade
(14.3%) students; higher among 12th-grade (26.5%) than 10th-grade (19.6%) and 11th-grade (21.6%) students;
higher among 10th-grade female (19.1%), 11th-grade
female (19.6%), and 12th-grade female (25.5%) than 9th-grade
female (12.3%) students; higher among 12th-grade female (25.5%) than 10th-grade female (19.1%) and 11th-grade
female (19.6%) students; higher among 11th-grade male (23.4%) and 12th-grade male (27.4%) than 9th-grade male
(16.2%) students; and higher among 12th-grade male (27.4%) than 10th-grade male (20.0%) students. Prevalence of
current cigarette use ranged from 7.9% to 27.6% across state surveys (median: 20.0%) and from 6.2% to 15.3% across
local surveys (median: 11.4%) (Table 28).

Current Frequent Cigarette Use

Nationwide, 8.1% of students had smoked cigarettes on 20 or more days during the 30 days before the survey
(i.e., current frequent cigarette use) (Table 27). Overall, the prevalence of current frequent cigarette use was higher
among male (8.7%) than female (7.4%) students and higher among black male (5.8%) than black female (2.1%)
students. Overall, the prevalence of current frequent cigarette use was higher among white (10.4%) than black (3.9%)
and Hispanic (4.2%) students; higher among white female (10.2%) than black female (2.1%) and Hispanic female
(3.3%) students; and higher among white male (10.6%) than black male (5.8%) and Hispanic male (5.1%) students.
Overall, the prevalence of current frequent cigarette use was higher among 10th-grade (7.0%), 11th-grade (10.1%), and
12th-grade (12.2%) than 9th-grade (4.3%) students; higher among 11th-grade (10.1%) and 12th-grade (12.2%)
than 10th-grade (7.0%) students; higher among 10th-grade female (6.8%), 11th-grade female (9.7%), and
12th-grade female (11.3%) than 9th-grade female (3.3%) students; higher among 12th-grade female (11.3%) than
10th-grade female (6.8%) students; and higher among 11th-grade male (10.5%) and 12th-grade male (13.1%) than
9th-grade male (5.4%) and 10th-grade male (7.2%) students. Prevalence of current frequent cigarette use ranged from 2.5%
to 14.4% across state surveys (median: 8.1%) and from 1.8% to 5.8% across local
surveys (median: 3.0%) (Table 28).

Smoked More than 10 Cigarettes per Day

Among the 20.0% of students nationwide who currently smoked
cigarettes,10.7% of students had smoked more
than 10 cigarettes per day on the days they smoked during the 30 days before the survey (Table 29). Overall, the
prevalence of having smoked more than 10 cigarettes per day was higher among male (13.8%) than female (7.1%) students;
higher among white male (15.7%) and black male (8.6%) than white female (8.0%) and black female (1.7%)
students, respectively; higher among 10th-grade male (12.6%) and 12th-grade male (19.2%) than 10th-grade female (5.3%)
and 12th-grade female (7.8%) students, respectively. Overall, the prevalence of having smoked more than 10 cigarettes
per day was higher among white (11.9%) than black (6.1%) and Hispanic (6.8%) students; higher among white
female (8.0%) than black female (1.7%) students; and higher among white male (15.7%) than black male (8.6%)
and Hispanic male (8.4%) students. The prevalence of having smoked more than 10 cigarettes per day was higher
among 12th-grade male (19.2%) than 11th-grade male (9.9%) students. The prevalence of having smoked more than
10 cigarettes per day ranged from 4.1% to 20.3% across state surveys (median: 9.7%) and from 1.9% to 12.8%
across local surveys (median: 7.4%) (Table 30).

Tried to Quit Smoking Cigarettes

Among the 20.0% of students nationwide who currently smoked cigarettes, 49.7% had tried to quit
smoking cigarettes during the 12 months before the survey (Table 29). Overall, the prevalence of having tried to quit
smoking cigarettes was higher among female (55.1%) than male (45.1%) students; higher among white female (55.6%)
and black female (67.5%) than white male (43.8%) and black male (53.6%) students, respectively; and higher among
11th-grade female (56.1%) and 12th-grade female (56.4%) than 11th-grade male (44.9%) and 12th-grade male
(41.1%) students, respectively. Overall, the prevalence of having tried to quit smoking cigarettes was higher among
black (58.4%) than white (49.4%) and Hispanic (48.3%) students; and higher among black female (67.5%) than
white female (55.6%) and Hispanic female (47.2%) students. The prevalence of having tried to quit smoking cigarettes
ranged from 43.4% to 62.5% across state surveys (median: 55.7%) and from 41.4% to 64.2% across local surveys
(median: 55.5%) (Table 30).

Bought Cigarettes in a Store or Gas Station

Nationwide, 16.0% of the 16.1% of students who currently smoked cigarettes and were aged <18 years
usually obtained their own cigarettes by buying them in a store (i.e., convenience store, supermarket, or discount store) or
gas station during the 30 days before the survey (Table 31). Overall, the prevalence of having bought their own cigarettes
in a store or gas station was higher among male (20.0%) than female (11.3%) students; higher among white male
(20.4%) than white female (10.9%) students; and higher among 10th-grade male (20.2%), 11th-grade male (20.9%),
and 12th-grade male (34.8%) than 10th-grade female (9.4%), 11th-grade female (13.6%), and 12th-grade female
(17.0%) students, respectively. Overall, the prevalence of having bought their own cigarettes in a store or gas station was
higher among 11th-grade (17.8%) and 12th-grade (25.6%) than 9th-grade (9.7%) students; higher among
12th-grade (25.6%) than 10th-grade (15.0%) and 11th-grade (17.8%) students; higher among 11th-grade female (13.6%)
and 12th-grade female (17.0%) than 9th-grade female (7.0%) students; higher among 10th-grade male (20.2%),
11th-grade male (20.9%), and 12th-grade male (34.8%) than 9th-grade male (11.8%) students; and higher among
12th-grade male (34.8%) than 10th-grade male (20.2%) and 11th-grade male (20.9%) students. Prevalence of
having bought their own cigarettes in a store or gas station ranged from 3.0% to 27.0% across state surveys (median:
14.1%) and from 10.2% to 39.4% across local surveys (median: 23.2%) (Table 32).

Current Smokeless Tobacco Use

Nationwide, 7.9% of students had used smokeless
tobacco (e.g., chewing tobacco, snuff, or dip) on at least
1 day during the 30 days before the survey (i.e., current smokeless tobacco use) (Table 31). Overall, the prevalence of
current smokeless tobacco use was higher among male (13.4%) than female (2.3%) students; higher among white
male (18.0%), black male (2.0%), and Hispanic male (6.7%) than white female (2.5%), black female (0.5%), and
Hispanic female (2.7%) students, respectively; and higher among 9th-grade male (10.4%), 10th-grade male (14.4%),
11th-grade male (13.3%), and 12th-grade male (15.9%) than 9th-grade female (2.0%), 10th-grade female (2.8%),
11th-grade
female (2.0%), and 12th-grade female (2.2%) students, respectively. Overall, the prevalence of current
smokeless tobacco use was higher among white (10.3%) than black (1.2%) and Hispanic (4.7%) students; higher among
Hispanic (4.7%) than black (1.2%) students; higher among white female (2.5%) and Hispanic female (2.7%) than black
female (0.5%) students; higher among white male (18.0%) than black male (2.0%) and Hispanic male (6.7%) students;
and higher among Hispanic male (6.7%) than black male (2.0%) students. Overall, the prevalence of current
smokeless tobacco use was higher among 10th-grade (8.7%) and 12th-grade (8.9%) than 9th-grade (6.3%) students; and
higher among 10th-grade male (14.4%) and 12th-grade male (15.9%) than 9th-grade male (10.4%) students. Prevalence
of current smokeless tobacco use ranged from 4.2% to 15.8% across state surveys (median: 8.6%) and from 1.0% to
7.2% across local surveys (median: 3.2%) (Table 32).

Current Cigar Use

Nationwide, 13.6% of students had smoked cigars, cigarillos, or little cigars on at least 1 day during the 30
days before the survey (i.e., current cigar use) (Table 33). Overall, the prevalence of current cigar use was higher among
male (19.4%) than female (7.6%) students; higher among white male (22.0%), black male (13.2%), and Hispanic
male (16.3%) than white female (7.4%), black female (6.7%), and Hispanic female (9.0%) students, respectively; and
higher among 9th-grade male (13.5%), 10th-grade male (16.9%), 11th-grade male (23.2%), and 12th-grade male
(26.2%) than 9th-grade female (6.1%), 10th-grade female (7.9%), 11th-grade female (7.6%), and 12th-grade female
(9.2%) students, respectively. Overall, the prevalence of current cigar use was higher among white (14.8%) than black
(10.0%) and Hispanic (12.7%) students; higher among Hispanic (12.7%) than black (10.0%) students; and higher
among white male (22.0%) than black male (13.2%) and Hispanic male (16.3%) students. Overall, the prevalence of
current cigar use was higher among 11th-grade (15.5%) and 12th-grade (17.6%) than 9th-grade (9.9%) and
10th-grade (12.5%) students; higher among 12th-grade female (9.2%) than 9th-grade female (6.1%) students; and higher
among 11th-grade male (23.2%) and 12th-grade male (26.2%) than 9th-grade male (13.5%) and 10th-grade male (16.9%
) students. Prevalence of current cigar use ranged from 7.0% to 18.9% across state surveys (median: 14.5%) and
from 4.5% to 16.9% across local surveys (median: 10.1%) (Table 34).

Alcohol and Other Drug Use

Nationwide, 75.0% of students had had at least one drink of alcohol on at least 1 day during their life (i.e.,
lifetime alcohol use) (Table 35). The prevalence of lifetime alcohol use was higher among 12th-grade female (85.2%) than
12th-grade male (80.2%) students. Overall, the prevalence of lifetime alcohol use was higher among white (76.1%)
and Hispanic (77.9%) than black (69.1%) students; higher among white female (76.4%) and Hispanic female
(79.3%) than black female (70.0%) students; and higher among white male (75.8%) and Hispanic male (76.5%) than
black male (68.4%) students. Overall, the prevalence of lifetime alcohol use was higher among 10th-grade (74.7%),
11th-grade (79.4%), and 12th-grade (82.8%) than 9th-grade (65.5%) students; higher among 11th-grade (79.4%)
and 12th-grade (82.8%) than 10th-grade (74.7%) students; higher among 12th-grade (82.8%) than 11th-grade
(79.4%) students; higher among 10th-grade female (74.6%), 11th-grade female (79.1%), and 12th-grade
female (85.2%) than 9th-grade female (66.1%) students; higher among 12th-grade female (85.2%) than 10th-grade female (74.6%)
and 11th-grade female (79.1%) students; higher among 10th-grade male (74.9%), 11th-grade male (79.7%), and
12th-grade male (80.2%) than 9th-grade male (65.0%) students; and higher among 11th-grade male (79.7%) and
12th-grade male (80.2%) than 10th-grade male (74.9%) students. Prevalence of lifetime alcohol use ranged from 36.7%
to 78.2% across state surveys (median: 73.5%) and from 53.2% to 74.8% across local surveys (median: 66.7%)
(Table 36).

Current Alcohol Use

Nationwide, 44.7% of students had had at least one drink of alcohol on at least 1 day during the 30 days before
the survey (i.e., current alcohol use) (Table 35). The prevalence of current alcohol use was higher among 11th-grade
male (51.5%) than 11th-grade female (46.5%) students. Overall, the prevalence of current alcohol use was higher
among white (47.3%) and Hispanic (47.6%) than black (34.5%) students; higher among white female (47.1%) and
Hispanic female (47.5%) than black female (34.9%) students; and higher among white male (47.4%) and Hispanic
male (47.7%) than black male (34.1%) students. Overall, the prevalence of current alcohol use was higher among
10th-grade (41.8%), 11th-grade (49.0%), and 12th-grade (54.9%) than 9th-grade (35.7%) students; higher among
11th-grade (49.0%) and 12th-grade (54.9%) than 10th-grade (41.8%) students; higher among 12th-grade (54.9%) than
11th-grade (49.0%) students; higher among 11th-grade female (46.5%) and 12th-grade female (54.2%) than
9th-grade female (37.2%) students; higher among 12th-grade female (54.2%) than 10th-grade female (42.3%) and
11th-grade female (46.5%) students; higher among 10th-grade male (41.4%), 11th-grade male (51.5%), and 12th-grade
male (55.6%) than 9th-grade male (34.3%) students; and higher among 11th-grade male (51.5%) and 12th-grade
male (55.6%) than 10th-grade male (41.4%) students. Prevalence of current alcohol use ranged from 17.0% to 48.9%
across state surveys (median: 42.9%) and from 22.3% to 44.3% across local surveys (median: 36.4%) (Table 36).

Episodic Heavy Drinking

Nationwide, 26.0% of students had had five or more drinks of alcohol in a row (i.e., within a couple of hours) on
at least 1 day during the 30 days before the survey (i.e., episodic heavy drinking) (Table 37). Overall, the prevalence
of episodic heavy drinking was higher among male (27.8%) than female (24.1%) students; higher among black
male (14.5%) than black female (10.7%) students; and higher among 11th-grade male (33.1%) and 12th-grade
male (40.4%) than 11th-grade female (26.7%) and 12th-grade female (32.8%) students, respectively. Overall, the
prevalence of episodic heavy drinking was higher among white (29.8%) and Hispanic (26.8%) than black (12.5%)
students; higher among white female (27.9%) and Hispanic female (25.3%) than black female (10.7%) students; and
higher among white male (31.8%) and Hispanic male (28.3%) than black male (14.5%) students. Overall, the prevalence
of episodic heavy drinking was higher among 10th-grade (23.7%), 11th-grade (29.9%), and 12th-grade (36.5%)
than 9th-grade (17.0%) students; higher among 11th-grade (29.9%) and 12th-grade (36.5%) than 10th-grade
(23.7%) students; higher among 12th-grade (36.5%) than 11th-grade (29.9%) students; higher among 10th-grade
female (21.8%), 11th-grade female (26.7%), and 12th-grade female (32.8%) than 9th-grade female (17.2%) students;
higher among 12th-grade female (32.8%) than 10th-grade female (21.8%) and 11th-grade female (26.7%) students;
higher among 10th-grade male (25.5%), 11th-grade male (33.1%), and 12th-grade male (40.4%) than 9th-grade
male
(17.0%) students; higher among 11th-grade male (33.1%) and 12th-grade male (40.4%) than 10th-grade
male (25.5%) students; and higher among 12th-grade male (40.4%) than 11th-grade male (33.1%) students. Prevalence
of episodic heavy drinking ranged from 11.7% to 32.7% across state surveys
(median: 26.2%) and from 8.7% to 24.6% across local surveys (median: 18.5%) (Table 38).

Bought Alcohol in a Store

Nationwide, 5.2% of the 44.7% students who currently drank alcohol usually obtained the alcohol they drank
by buying it in a store (e.g., liquor store, convenience store, supermarket, discount store, or gas station) during the 30
days before the survey (Table 37). Overall, the prevalence of having bought alcohol in a store was higher among male
(7.6%) than female (2.7%) students; higher among white male (6.9%) and Hispanic male (9.8%) than white female
(2.2%) and Hispanic female (3.6%) students, respectively; and higher among 9th-grade male (5.1%), 11th-grade male
(9.1%), and 12th-grade male (11.1%) than 9th-grade
female (1.1%), 11th-grade female (2.0%), and 12th-grade female
(5.0%) students, respectively. Overall, the prevalence of having bought alcohol in a store was higher among 12th-grade
(8.0%) than 9th-grade (3.1%) students; higher among 11th-grade (5.6%) and 12th-grade (8.0%) than 10th-grade
(3.6%) students; higher among 12th-grade female (5.0%) than 9th-grade female (1.1%) and 11th-grade female
(2.0%) students; higher among 12th-grade male (11.1%) than 9th-grade male (5.1%) students; and higher among
11th-grade male (9.1%) and 12th-grade male (11.1%) than 10th-grade male (4.6%) students. Prevalence of having bought
alcohol in a store ranged from 1.8% to 10.0% across state surveys (median: 4.1%) and from 4.5% to 16.2% across local
surveys (median: 9.0%) (Table 38).

Nationwide, 19.7% of students had used marijuana one or more times during the 30 days before the survey
(i.e., current marijuana use) (Table 39). Overall, the prevalence of current marijuana use was higher among male
(22.4%) than female (17.0%) students; higher among white male (22.7%) and black male (26.0%) than white female
(17.0%) and black female (17.1%) students, respectively; and higher among 9th-grade male (16.9%), 10th-grade male
(22.0%), 11th-grade male (25.2%), and 12th-grade male (27.8%) than 9th-grade female (12.5%), 10th-grade female
(16.5%), 11th-grade female (17.5%), and 12th-grade female (22.6%) students, respectively. The prevalence of current
marijuana use was higher among black male (26.0%) than Hispanic male (20.5%) students. Overall, the prevalence of
current marijuana use was higher among 10th-grade (19.3%), 11th-grade (21.4%), and 12th-grade (25.1%) than
9th-grade (14.7%) students; higher among 12th-grade (25.1%) than 10th-grade (19.3%) students; higher among
10th-grade female (16.5%), 11th-grade female (17.5%), and 12th-grade female (22.6%) than 9th-grade female (12.5%)
students; higher among 12th-grade female (22.6%) than 10th-grade female (16.5%) students; higher among 10th-grade
male (22.0%), 11th-grade male (25.2%), and 12th-grade male (27.8%) than 9th-grade male (16.9%) students; and
higher
among 12th-grade male (27.8%) than 10th-grade male (22.0%) students. Prevalence of current marijuana use
ranged from 8.7% to 25.1% across state surveys (median: 19.0%) and from 11.4% to 26.8% across local surveys
(median: 18.4%) (Table 40).

Lifetime Cocaine Use

Nationwide, 7.2% of students had used any form of
cocaine (e.g., powder, crack,** or
freebase) one or more times during their life (i.e., lifetime cocaine use)
(Table 41). Overall, the prevalence of lifetime cocaine use was higher
among male (7.8%) than female (6.5%) students; higher among black male (2.8%) than black female (0.9%) students;
and higher among 12th-grade male (11.4%) than 12th-grade female (7.6%) students. Overall, the prevalence of
lifetime cocaine use was higher among white (7.4%) than black (1.8%) students; higher among Hispanic (10.9%) than
white (7.4%) and black (1.8%) students; higher among white female (6.9%) than black female (0.9%) students;
higher among Hispanic female (10.2%) than white female (6.9%) and black female (0.9%) students; and higher among
white male (7.9%) and Hispanic male (11.5%) than black male (2.8%) students. Overall, the prevalence of lifetime
cocaine use was higher among 10th-grade (7.2%), 11th-grade (7.7%), and 12th-grade (9.5%) than 9th-grade (4.8%)
students; higher among 12th-grade (9.5%) than 10th-grade (7.2%) students; higher among 12th-grade female (7.6%) than
9th-grade female (4.7%) students; higher among 10th-grade male (7.7%), 11th-grade male (8.0%), and 12th-grade
male (11.4%) than 9th-grade male (5.0%) students; and higher among 12th-grade male (11.4%) than 10th-grade
male (7.7%) and 11th-grade male (8.0%) students. Prevalence of lifetime cocaine use ranged from 5.2% to 14.4%
across state surveys (median: 7.4%) and from 0.9% to 12.6% across local surveys (median: 5.9%) (Table 42).

Current Cocaine Use

Nationwide, 3.3% of students had used any form of
cocaine (e.g., powder, crack, or freebase) one or more
times during the 30 days before the survey (i.e., current cocaine use) (Table 41). Overall, the prevalence of current cocaine
use was higher among male (4.0%) than female (2.5%) students; higher among Hispanic male (6.7%) than
Hispanic female (3.9%) students; and higher among 12th-grade male (6.0%) than 12th-grade female (2.8%) students.
Overall, the prevalence of current cocaine use was higher among white (3.0%) than black (1.1%) students; higher
among Hispanic (5.3%) than white (3.0%) and black (1.1%) students; higher among white female (2.6%) and
Hispanic female (3.9%) than black female (0.5%) students; higher among white male (3.4%) than black male (1.7%)
students; and higher among Hispanic male (6.7%) than white male (3.4%) and black male (1.7%) students. Overall,
the prevalence of current cocaine use was higher among 12th-grade (4.4%) than 9th-grade (2.7%) and 11th-grade
(2.9%) students and higher among 12th-grade male (6.0%) than 9th-grade male (3.0%), 10th-grade male (3.7%), and
11th-grade male (3.5%) students. Prevalence of current cocaine use ranged from 1.7% to 6.6% across state surveys
(median: 3.3%) and from 0.5% to 6.2% across local surveys (median: 2.9%) (Table 42).

Lifetime Illegal Injection-Drug Use

Nationwide, 2.0% of students had used a needle to
inject any illegal drug into their body one or more times
during their life (i.e., lifetime illegal injection-drug use) (Table 43). Overall, the prevalence of lifetime illegal
injection-drug use was higher among male (2.6%) than female (1.3%) students; higher among white male (2.0%) and black male
(2.8%) than white female (1.1%) and black female (0.8%) students, respectively; and higher among 9th-grade male
(2.7%) and 12th-grade male (4.1%) than 9th-grade female (1.3%) and 12th-grade female (0.7%) students,
respectively. Overall, the prevalence of lifetime illegal injection-drug use was higher among Hispanic (3.1%) than white (1.5%)
and black (1.8%) students; higher among Hispanic female (2.5%) than white female (1.1%) and black female
(0.8%) students; and higher among Hispanic male (3.6%) than white male (2.0%) students. The prevalence of lifetime
illegal injection-drug use was higher among 10th-grade female (1.6%) and 11th-grade female (1.4%) than 12th-grade
female (0.7%) students; higher among 9th-grade male (2.7%), 11th-grade male (2.3%), and 12th-grade male (4.1%)
than 10th-grade male (1.3%) students; and higher among 12th-grade male (4.1%) than 11th-grade male (2.3%)
students. Prevalence of lifetime illegal injection-drug use ranged from 1.1% to 4.7% across state surveys (median: 2.6%) and
from 0.5% to 5.5% across local surveys (median: 2.4%) (Table 44).

Lifetime Inhalant Use

Nationwide, 13.3% of students had sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints
or sprays to get high one or more times during their life (i.e., lifetime inhalant use) (Table 43). Overall, the prevalence
of lifetime inhalant use was higher among female (14.3%) than male (12.4%) students; higher among white
female (15.6%) than white male (13.1%) students; and higher among 9th-grade female (17.2%) and 10th-grade
female (16.6%) than 9th-grade male (13.0%) and 10th-grade male (12.5%) students, respectively. Overall, the prevalence
of lifetime inhalant use was higher among white (14.4%) and Hispanic (14.1%) than black (8.5%) students;
higher among white female (15.6%) and Hispanic female (15.5%) than black female (7.9%) students; and higher
among white male (13.1%) than black male (9.2%) students. Overall, the prevalence of lifetime inhalant use was higher
among 9th-grade (15.0%), 10th-grade (14.6%), and 11th-grade (12.5%) than 12th-grade (10.2%)
students and higher among 9th-grade female (17.2%) and 10th-grade female (16.6%) than 11th-grade female (12.4%) and
12th-grade female (9.7%) students. Prevalence of lifetime inhalant use ranged from 9.8% to 19.2% across state surveys
(median: 12.8%) and from 6.9% to 17.4% across local surveys (median: 10.0%) (Table 44).

Lifetime Illegal Steroid Use

Nationwide, 3.9% of students had taken steroid pills or shots without a doctor's prescription one or more
times during their life (i.e., lifetime illegal steroid use)
(Table 45). Overall, the prevalence of lifetime illegal steroid use
was higher among male (5.1%) than female (2.7%) students; higher among white male (5.3%) and black male (3.4%)
than white female (2.8%) and black female (1.0%) students, respectively; and higher among 11th-grade male (4.4%)
and 12th-grade male (5.6%) than 11th-grade female (1.9%) and 12th-grade female (1.9%) students,
respectively. Overall, the prevalence of lifetime illegal steroid use was higher among white (4.1%) and Hispanic (4.6%) than black
(2.2%) students; higher among white female (2.8%) and Hispanic female (4.5%) than black
female (1.0%) students; and higher among white male (5.3%) than black male (3.4%) students. The prevalence of lifetime illegal steroid use
was higher among 9th-grade female (3.8%) than 11th-grade female (1.9%) and 12th-grade female (1.9%) students
and higher among 10th-grade female (2.9%) than 11th-grade female (1.9%) students. Prevalence of lifetime illegal
steroid use ranged from 1.8% to 6.1% across state surveys (median: 3.9%) and from 1.6% to 6.5% across local
surveys (median: 3.0%) (Table 46).

Nationwide, 2.3% of students had used heroin (also called "smack," "junk," or "China White") one or more
times during their life (i.e., lifetime heroin use) (Table 47). Overall, the prevalence of lifetime heroin use was higher
among male (2.9%) than female (1.6%) students; higher among black male (2.9%) than black female (0.7%) students;
and higher among 11th-grade male (2.4%) and 12th-grade male (4.0%) than 11th-grade female (1.2%) and
12th-grade female (1.3%) students, respectively. Overall, the prevalence of lifetime heroin use was higher among Hispanic
(3.7%)
than white (1.7%) and black (1.8%) students; higher among Hispanic female (3.3%) than white female (1.3%)
and black female (0.7%) students; and higher among Hispanic male (4.0%) than white male (2.1%) students. Overall,
the prevalence of lifetime heroin use was higher among 12th-grade (2.6%) than 10th-grade (1.8%) students and
higher among 12th-grade male (4.0%) than 10th-grade male (1.9%) students. Prevalence of lifetime heroin use ranged
from 1.4% to 5.6% across state surveys (median: 3.0%) and from 0.6% to 5.4% across local
surveys (median: 2.8%) (Table 48).

Lifetime Methamphetamine Use

Nationwide, 4.4% of students had used methamphetamines (also called "speed," "crystal," "crank," or "ice") one
or more times during their life (i.e., lifetime methamphetamine use) (Table 47). The prevalence of
lifetime methamphetamine use was higher among black male (3.0%) than black female (0.8%) students and higher
among 12th-grade male (5.6%) than 12th-grade female (3.5%) students. Overall, the prevalence of lifetime
methamphetamine use was higher among white (4.5%) and Hispanic (5.7%) than black (1.9%) students; higher among white
female (4.5%) and Hispanic female (5.3%) than black female (0.8%) students; and higher among Hispanic male (6.1%)
than black male (3.0%) students. The prevalence of lifetime methamphetamine use was higher among 11th-grade
female (5.3%) than 12th-grade female (3.5%) students. Prevalence of lifetime methamphetamine use ranged from 3.0%
to 8.6% across state surveys (median: 4.8%) and from 0.7% to 9.0% across local surveys (median: 3.8%) (Table 48).

Lifetime Ecstasy Use

Nationwide, 5.8% of students had used ecstasy (also called "MDMA") one or more times during their life
(i.e., lifetime ecstasy use) (Table 49). Overall, the prevalence of lifetime ecstasy use was higher among male (6.7%)
than female (4.8%) students; higher among white male (6.5%) and black male (5.1%) than white female (4.6%) and
black female (2.4%) students, respectively; and higher among 9th-grade male (5.9%) and 12th-grade male (9.6%) than
9th-grade female (3.3%) and 12th-grade female (5.6%) students, respectively. Overall, the prevalence of lifetime ecstasy
use was higher among white (5.6%) than black (3.7%) students; higher among Hispanic (7.4%) than white (5.6%)
and black (3.7%) students; higher among white female (4.6%) than black female (2.4%) students; and higher
among Hispanic female (6.9%) than white female (4.6%) and black female (2.4%) students. Overall, the prevalence of
lifetime ecstasy use was higher among 12th-grade (7.6%) than 9th-grade (4.6%), 10th-grade (5.3%), and 11th-grade
(5.6%) students; higher among 12th-grade female (5.6%) than 9th-grade female (3.3%) students; and higher among
12th-grade male (9.6%) than 9th-grade male (5.9%), 10th-grade male (5.7%), and 11th-grade male (6.0%)
students. Prevalence of lifetime ecstasy use ranged from 3.0% to 9.9% across state surveys (median: 6.6%) and from 2.5%
to 10.3% across local surveys (median: 6.5%) (Table 50).

Age of Initiation of Risk Behaviors

Smoked a Whole Cigarette Before Age 13 Years

Nationwide, 14.2% of students had smoked a whole cigarette for the first time before age 13 years (Table 51). Overall, the prevalence of having smoked a whole cigarette before age 13 years was higher among male (16.4%)
than female (11.9%) students; higher among white male (16.5%), black male (14.6%), and Hispanic male (16.8%)
than white female (12.2%), black female (10.5%), and Hispanic female (11.9%) students, respectively; and higher
among 9th-grade male (19.2%), 11th-grade male (14.6%), and 12th-grade male (15.2%) than 9th-grade female
(13.2%), 11th-grade female (9.2%), and 12th-grade female (11.5%) students, respectively. Overall, the prevalence of
having smoked a whole cigarette before age 13 years was higher among 9th-grade (16.3%) than 11th-grade (12.0%) and
12th-grade (13.3%) students; higher among 9th-grade
female (13.2%) and 10th-grade female (12.9%) than
11th-grade female (9.2%) students; and higher among 9th-grade male (19.2%) than 10th-grade male (15.7%), 11th-grade
male (14.6%), and 12th-grade male (15.2%) students. Prevalence of having smoked a whole cigarette before age 13
years ranged from 8.6% to 23.8% across state surveys (median: 14.1%) and from 8.0% to 17.4% across local
surveys (median: 11.0%) (Table 52).

Drank Alcohol Before Age 13 Years

Nationwide, 23.8% of students had drunk alcohol (other than a few sips) for the first time before age 13
years (Table 51). Overall, the prevalence of having drunk alcohol before age 13 years was higher among male (27.4%)
than female (20.0%) students; higher among white male (25.0%), black male (30.7%), and Hispanic male (33.6%)
than white female (17.8%), black female (22.7%), and Hispanic female (24.2%) students, respectively; and higher
among 9th-grade male (34.5%), 10th-grade male (26.6%), 11th-grade male (25.1%), and 12th-grade male (21.2%) than
9th-grade female (27.1%), 10th-grade female (22.2%), 11th-grade female (13.8%), and 12th-grade
female (14.8%) students, respectively. Overall, the prevalence of having drunk alcohol before age 13 years was higher among
black (26.7%) and Hispanic (29.0%) than white (21.5%) students; higher among black female (22.7%) and Hispanic
female (24.2%) than white female (17.8%) students; and higher among black male (30.7%) and Hispanic male (33.6%)
than white male (25.0%) students. Overall, the prevalence of having drunk alcohol before age 13 years was higher
among 9th-grade (30.9%) than 10th-grade (24.4%), 11th-grade (19.6%), and 12th-grade (18.0%) students; higher
among 10th-grade (24.4%) than 11th-grade (19.6%) and 12th-grade (18.0%) students; higher among 9th-grade
female (27.1%) than 10th-grade female (22.2%), 11th-grade female (13.8%), and 12th-grade female (14.8%)
students; higher among 10th-grade female (22.2%) than 11th-grade female (13.8%) and 12th-grade female (14.8%)
students; higher among 9th-grade male (34.5%) than 10th-grade male (26.6%), 11th-grade male (25.1%), and 12th-grade
male (21.2%) students; and higher among 10th-grade male (26.6%) than 12th-grade male (21.2%) students. Prevalence
of having drunk alcohol before age 13 years ranged from 13.0% to 30.7% across state surveys (median: 23.0%) and
from 18.3% to 29.2% across local surveys (median: 24.4%) (Table 52).

Tried Marijuana Before Age 13 Years

Nationwide, 8.3% of students had tried marijuana for the first time before age 13 years (Table 53). Overall,
the prevalence of having tried marijuana before age 13 years was higher among male (11.2%) than female (5.2%)
students; higher among white male (10.0%), black male (14.2%), and Hispanic male (12.4%) than white female (4.4%),
black female (4.9%), and Hispanic female (7.1%) students, respectively; and higher among 9th-grade male (13.3%),
10th-grade male (11.7%), 11th-grade male (10.1%), and 12th-grade male (9.1%) than 9th-grade
female (6.1%), 10th-grade female (5.7%), 11th-grade
female (4.2%), and 12th-grade female (4.2%) students, respectively. Overall, the
prevalence of having tried marijuana before age 13 years was higher among Hispanic (9.8%) than white (7.2%) students
and higher among Hispanic female (7.1%) than white female (4.4%) students. Overall, the prevalence of having
tried marijuana before age 13 years was higher among 9th-grade (9.8%) than 11th-grade (7.2%) and 12th-grade
(6.6%) students; higher among 10th-grade (8.7%) than 12th-grade (6.6%) students; higher among 9th-grade female
(6.1%) than 12th-grade female (4.2%) students; and higher among 9th-grade male (13.3%) and 10th-grade male
(11.7%) than 12th-grade male (9.1%) students. Prevalence of having tried marijuana before age 13 years ranged from 4.4%
to 18.2% across state surveys (median: 8.7%) and from 5.5% to 16.1% across local surveys (median: 9.7%) (Table 54).

Tobacco, Alcohol, and Other Drug Use on School Property

Smoked Cigarettes on School Property

Nationwide, 5.7% of students had smoked cigarettes on school property on at least 1 day during the 30 days
before the survey (Table 55). Overall, the prevalence of having smoked cigarettes on school property was higher among
male (6.5%) than female (4.8%) students; higher among white male (7.1%) and black male (5.1%) than
white female (5.6%) and black female (1.7%) students, respectively; and higher among 11th-grade male (7.2%) and
12th-grade male (8.9%) than 11th-grade female (4.7%) and 12th-grade female (5.9%) students, respectively. Overall,
the prevalence of having smoked cigarettes on school property was higher among white (6.4%) and Hispanic (4.9%)
than black (3.4%) students; and higher among white female (5.6%) and Hispanic female (4.2%) than black female
(1.7%) students. Overall, the prevalence of having smoked cigarettes on school property was higher among 12th-grade
(7.4%)
than 9th-grade (4.2%) and 10th-grade (5.4%) students and higher among 12th-grade male (8.9%) than
9th-grade male (4.7%) and 10th-grade male (5.8%) students. Prevalence of having smoked cigarettes on school property
ranged from 2.4% to 9.5% across state surveys (median: 6.3%) and from 2.2% to 5.8% across local surveys (median:
3.7%) (Table 56).

Used Smokeless Tobacco on School Property

Nationwide, 4.9% of students had used smokeless
tobacco (e.g., chewing tobacco, snuff, or dip) on school property
on at least 1 day during the 30 days before the survey (Table 55). Overall, the prevalence of having used smokeless
tobacco on school property was higher among male (8.9%) than female (1.0%) students; higher among white male
(11.3%), black male (1.5%), and Hispanic male (4.9%) than white female (1.0%), black female (0.2%), and Hispanic
female (1.5%) students, respectively; and higher among 9th-grade male (6.9%), 10th-grade male (10.4%), 11th-grade
male (7.9%), and 12th-grade male (10.2%) than 9th-grade female (0.9%), 10th-grade female (1.3%), 11th-grade
female (0.6%), and 12th-grade female (1.0%) students, respectively. Overall, the prevalence of having used smokeless
tobacco on school property was higher among white (6.2%) than black (0.9%) and Hispanic (3.2%) students; higher
among Hispanic (3.2%) than black (0.9%) students; higher among white female (1.0%) and Hispanic female (1.5%)
than black female (0.2%) students; higher among white male (11.3%) than black male (1.5%) and Hispanic male
(4.9%) students; and higher among Hispanic male (4.9%) than black male (1.5%) students. Overall, the prevalence of
having used smokeless tobacco on school property was higher among 10th-grade (5.9%) than 9th-grade (4.0%) and
11th-grade (4.2%) students and higher among 10th-grade male (10.4%) than 9th-grade male (6.9%) students. Prevalence
of having used smokeless tobacco on school property ranged from 1.9% to 10.6% across state surveys (median: 5.4%)
and from 0.5% to 3.8% across local surveys (median: 1.9%) (Table 56).

Drank Alcohol on School Property

Nationwide, 4.1% of students had drunk at least one drink of alcohol on school property on at least 1 day during
the 30 days before the survey (Table 57). Overall, the prevalence of having drunk alcohol on school property was
higher among male (4.6%) than female (3.6%) students; higher among white male (3.8%) than white female (2.6%)
students; and higher among 12th-grade male (6.3%) than 12th-grade female (3.4%) students. Overall, the prevalence of
having drunk alcohol on school property was higher among Hispanic (7.5%) than white (3.2%) and black (3.4%)
students; higher among Hispanic female (7.1%) than white female (2.6%) and black female (3.2%) students; and higher
among Hispanic male (7.8%) than white male (3.8%) and black male (3.7%) students. Overall, the prevalence of having
drunk alcohol on school property was higher among 12th-grade (4.8%) than 9th-grade (3.4%) students and higher
among 12th-grade male (6.3%) than 9th-grade male (3.4%) and 11th-grade male (4.5%) students. Prevalence of having
drunk alcohol on school property ranged from 3.2% to 8.7% across state surveys (median: 4.8%) and from 3.1% to
10.9% across local surveys (median: 4.8%) (Table 58).

Used Marijuana on School Property

Nationwide, 4.5% of students had used marijuana on school property one or more times during the 30
days before the survey (Table 57). Overall, the prevalence of having used marijuana on school property was higher
among male (5.9%) than female (3.0%) students; higher among white male (5.2%), black male (7.4%), and Hispanic
male (6.9%) than white female (2.7%), black female (2.6%), and Hispanic female (3.9%) students, respectively; and
higher among 9th-grade male (5.2%), 10th-grade male (6.5%), 11th-grade male (5.3%), and 12th-grade male (6.6%)
than 9th-grade female (2.7%), 10th-grade female (3.1%), 11th-grade female (2.7%), and 12th-grade female
(3.7%) students, respectively. Prevalence of having used marijuana on school property ranged from 2.5% to 7.9% across
state surveys (median: 4.2%) and from 2.7% to 8.4% across local surveys (median: 5.2%) (Table 58).

Offered, Sold, or Given an Illegal Drug on School Property

Nationwide, 22.3% of students had been offered, sold, or given an illegal drug by
someoneon school property during the 12 months before the survey (Table 59). Overall, the prevalence of having been offered, sold, or given an illegal
drug on school property was higher among male (25.7%) than female (18.7%) students; higher among white male
(24.0%) and black male (25.1%) than white female (17.4%) and black female (13.4%) students,
respectively; and higher among
9th-grade male (25.0%), 10th-grade male (29.5%), 11th-grade male (25.7%), and 12th-grade male (22.4%) than
9th-grade female (17.2%), 10th-grade female (21.0%), 11th-grade female (19.8%), and 12th-grade female
(16.8%) students, respectively. Overall, the prevalence of having been offered, sold, or given an illegal drug on school
property was higher among Hispanic (29.1%) than white (20.8%) and black (19.2%) students; higher among white
female (17.4%) than black female (13.4%) students; higher among Hispanic female (27.2%) than white female (17.4%)
and black female (13.4%) students; and higher among Hispanic male (30.9%) than white male (24.0%) and black
male (25.1%) students. Overall, the prevalence of having been offered, sold, or given an illegal drug on school property
was higher among 10th-grade (25.3%) than 9th-grade (21.2%), 11th-grade (22.8%), and 12th-grade (19.6%)
students; higher among 11th-grade (22.8%) than 12th-grade (19.6%) students; higher among 10th-grade female (21.0%)
than 12th-grade female (16.8%) students; and higher among 10th-grade male (29.5%) than 9th-grade male (25.0%)
and 12th-grade male (22.4%) students. Prevalence of having been offered, sold, or given an illegal drug on school
property ranged from 10.1% to 37.1% across state surveys (median: 25.1%) and from 13.5% to 39.2% across local
surveys (median: 27.1%) (Table 60).

Nationwide, 7.1% of students had had sexual intercourse for the first time before age 13 years (Table 61). Overall,
the prevalence of having had sexual intercourse before age 13 years was higher among male (10.1%) than female
(4.0%) students; higher among white male (5.7%), black male (26.2%), and Hispanic male (11.9%) than
white female (3.1%), black female (6.9%), and Hispanic female (4.5%) students, respectively; and higher among
9th-grade male (13.5%), 10th-grade male (9.1%), 11th-grade male (9.9%), and 12th-grade male (6.7%) than
9th-grade female (4.9%), 10th-grade female (4.7%), 11th-grade
female (3.4%), and 12th-grade female (2.4%)
students, respectively. Overall, the prevalence of having had sexual intercourse before age 13 years was higher among
black (16.3%) and Hispanic (8.2%) than white (4.4%) students; higher among black (16.3%) than Hispanic
(8.2%) students; higher among black female (6.9%) than white
female (3.1%) and Hispanic female (4.5%) students;
higher among black male (26.2%) and Hispanic male (11.9%) than white male (5.7%) students; and higher among
black male (26.2%) than Hispanic male (11.9%) students. Overall, the prevalence of having had sexual intercourse before
age
13 years was higher among 9th-grade (9.2%) than 10th-grade (6.9%), 11th-grade (6.6%), and 12th-grade
(4.5%) students; higher among 10th-grade (6.9%) than 12th-grade (4.5%) students; higher among 9th-grade female
(4.9%) and 10th-grade female (4.7%) than 12th-grade female (2.4%) students; higher among 9th-grade male (13.5%)
than 10th-grade male (9.1%), 11th-grade male (9.9%), and 12th-grade male (6.7%) students; and higher among
10th-grade male (9.1%) than 12th-grade male (6.7%)
students. Prevalence of having hadsexual intercourse
before age 13 years ranged from 3.0% to 13.3% across state surveys (median: 6.0%) and from 3.9% to 18.6% across local
surveys (median: 10.3%) (Table 62).

Had Sexual Intercourse with Four or More Persons During Their Life

Nationwide, 14.9% of students had had sexual
intercoursewith four or more persons during their life
(Table 63). Overall, the prevalence of having had sexual intercourse with four or more persons was higher among male (17.9%)
than female (11.8%) students; higher among black male (37.6%) and Hispanic male (23.3%) than black female
(18.1%) and Hispanic female (11.3%) students, respectively; and higher among 9th-grade male (11.9%), 10th-grade
male (16.7%), 11th-grade male (20.6%), and 12th-grade male (24.7%) than 9th-grade female (5.5%), 10th-grade
female (10.2%), 11th-grade female (13.1%), and 12th-grade
female (20.1%) students, respectively. Overall, the prevalence
of having had sexual intercourse with four or more persons was higher among black (27.6%) and Hispanic (17.3%)
than white (11.5%) students; higher among black (27.6%) than Hispanic (17.3%) students; higher among black
female (18.1%) than white female (10.6%) and Hispanic
female (11.3%) students; higher among black male (37.6%)
and Hispanic male (23.3%) than white male (12.2%) students; and higher among black male (37.6%) than Hispanic
male (23.3%) students. Overall, the prevalence of having had sexual intercourse with four or more persons was higher
among 10th-grade (13.4%), 11th-grade (17.0%), and 12th-grade (22.4%) than 9th-grade (8.7%) students; higher
among 11th-grade (17.0%) and 12th-grade (22.4%) than 10th-grade (13.4%) students; higher among 12th-grade
(22.4%) than 11th-grade (17.0%) students; higher among 10th-grade female (10.2%), 11th-grade female (13.1%), and
12th-grade female (20.1%) than 9th-grade female (5.5%) students; higher among 11th-grade female (13.1%) and
12th-grade female (20.1%) than 10th-grade female (10.2%) students; higher among 12th-grade female (20.1%)
than 11th-grade female (13.1%) students; higher among 10th-grade male (16.7%), 11th-grade male (20.6%), and
12th-grade male (24.7%) than 9th-grade male (11.9%) students; and higher among 11th-grade male (20.6%) and
12th-grade male (24.7%) than 10th-grade male (16.7%) students. Prevalence of having had sexual intercourse with four
or more persons ranged from 6.1% to 22.5% across state surveys (median: 13.8%) and from 6.5% to 29.6% across
local surveys (median: 16.6%) (Table 64).

Currently Sexually Active

Nationwide, 35.0% of students had had sexual
intercoursewith at least one person during the 3 months before
the survey (i.e., currently sexually active) (Table 63). The prevalence of being currently sexually active was higher
among white female (35.1%) than white male (30.6%) students and higher among 9th-grade male (22.2%) and
12th-grade female (56.7%) than 9th-grade female (18.0%) and 12th-grade male (48.3%) students, respectively. Overall,
the prevalence of being currently sexually active was higher among black (46.0%) and Hispanic (37.4%) than
white (32.9%) students; higher among black (46.0%) than Hispanic (37.4%) students; higher among black female
(43.5%) than white female (35.1%) and Hispanic female (35.3%) students; higher among black male (48.7%) and
Hispanic male (39.6%) than white male (30.6%) students; and higher among black male (48.7%) than Hispanic male
(39.6%) students. Overall, the prevalence of being currently sexually active was higher among 10th-grade (30.6%),
11th-grade (41.8%), and 12th-grade (52.6%) than 9th-grade (20.1%) students; higher among 11th-grade (41.8%) and
12th-grade (52.6%) than 10th-grade (30.6%) students; higher among 12th-grade (52.6%) than 11th-grade
(41.8%) students; higher among 10th-grade female (31.8%), 11th-grade female (41.5%), and 12th-grade female (56.7%)
than 9th-grade female (18.0%) students; higher among 11th-grade female (41.5%) and 12th-grade female (56.7%)
than 10th-grade female (31.8%) students; higher among 12th-grade female (56.7%) than 11th-grade female
(41.5%) students; higher among 10th-grade male (29.4%), 11th-grade male (42.0%), and 12th-grade male (48.3%) than
9th-grade male (22.2%) students; higher among 11th-grade male (42.0%) and 12th-grade male (48.3%) than
10th-grade male (29.4%) students; and higher among 12th-grade male (48.3%) than 11th-grade male (42.0%)
students.
Prevalence of being currently sexually active ranged from 23.6% to 45.3% across state surveys (median: 34.1%)
and from 17.5% to 49.7% across local surveys (median: 36.6%) (Table 64).

Condom Use

Among the 35.0% of currently sexually active students nationwide, 61.5% reported that either they or their
partner had used a condom during last sexual intercourse
(Table 65). Overall, the prevalence of having used a condom
during last sexual intercourse was higher among male (68.5%) than female (54.9%) students; higher among white
male (66.4%), black male (74.0%), and Hispanic male (69.9%) than white female (53.9%), black female (60.1%),
and Hispanic female (52.1%) students, respectively; and higher among 9th-grade male (75.8%), 10th-grade male
(73.2%), 11th-grade male (69.3%), and 12th-grade male (59.6%) than 9th-grade female (61.0%), 10th-grade female
(59.5%), 11th-grade female (55.1%), and 12th-grade female (49.9%) students, respectively. Overall, the prevalence of
having used a condom during last sexual intercourse was higher among black (67.3%) than white (59.7%) students and
higher among black male (74.0%) than white male (66.4%) students. Overall, the prevalence of having used a condom
during last sexual intercourse was higher among 9th-grade (69.3%) than 11th-grade (62.0%) and 12th-grade
(54.2%) students; higher among 10th-grade (66.1%) and 11th-grade (62.0%) than 12th-grade (54.2%) students;
higher among 9th-grade female (61.0%) and 10th-grade female (59.5%) than 12th-grade female (49.9%) students;
and higher among 9th-grade male (75.8%), 10th-grade male (73.2%), and 11th-grade male (69.3%) than 12th-grade
male (59.6%) students. Prevalence of having used a condom during last sexual intercourse ranged from 54.2% to
69.2% across state surveys (median: 61.5%) and from 57.0% to 74.3% across local surveys (median: 68.1%) (Table 66).

Birth Control Pill Use

Among the 35.0% of currently sexually active students nationwide, 16.0% reported
thateither they or their partner had used birth control pills to prevent pregnancy
before last sexual intercourse (Table 65). Overall, the prevalence
of having used birth control pills before last sexual intercourse was higher among female (18.7%) than male
(13.1%) students; higher among white female (24.0%) and black female (12.1%) than white male (17.0%) and black
male (6.3%) students, respectively; and higher among 11th-grade female (18.9%) than 11th-grade male (11.0%)
students. Overall, the prevalence of having used birth control pills before last sexual intercourse was higher among white
(20.8%) than black (9.1%) and Hispanic (9.1%) students; higher among white female (24.0%) than black female (12.1%)
and Hispanic female (9.1%) students; and higher among white male (17.0%) than black male (6.3%) and Hispanic
male (9.0%) students. Overall, the prevalence of having used birth control pills before last sexual intercourse was
higher among 11th-grade (15.0%) and 12th-grade (23.5%) than 9th-grade (8.7%) students; higher among
12th-grade (23.5%) than 10th-grade (11.6%) and 11th-grade (15.0%) students; higher among 11th-grade female (18.9%)
and 12th-grade female (25.6%) than 9th-grade female (9.2%) students; higher among 12th-grade female (25.6%)
than 10th-grade female (13.7%) and 11th-grade female (18.9%) students; and higher among 12th-grade male (20.8%)
than 9th-grade male (8.3%), 10th-grade male (9.5%), and 11th-grade male (11.0%) students. The prevalence of
having used birth control pills before last sexual intercourse ranged from 12.2% to 36.1% across state surveys (median:
18.9%) and from 6.3% to 16.9% across local surveys (median: 9.2%) (Table 66).

Drank Alcohol or Used Drugs Before Last Sexual Intercourse

Among the 35.0% of currently sexually active students nationwide, 22.5% had drunk alcohol or used
drugs before last sexual intercourse (Table 67). Overall, the prevalence of having drunk alcohol or used drugs before last
sexual intercourse was higher among male (27.5%) than female (17.7%) students; higher among white male (30.5%),
black male (19.8%), and Hispanic male (25.9%) than white female (19.8%), black female (12.9%), and Hispanic
female (16.5%) students, respectively; and higher among 11th-grade male (28.3%) and 12th-grade male (29.1%) than
11th-grade female (14.8%) and 12th-grade female (17.3%) students, respectively. Overall, the prevalence of having
drunk alcohol or used drugs before last sexual intercourse was higher among white (24.8%) and Hispanic (21.4%) than
black (16.4%) students; higher among white female (19.8%) than black female (12.9%) students; and higher among
white male (30.5%) and Hispanic male (25.9%) than black male (19.8%) students. Prevalence of having drunk alcohol
or used drugs before last sexual intercourse ranged from 17.6% to 28.1% across state surveys (median: 22.5%) and
from 12.2% to 25.5% across local surveys (median: 17.4%) (Table 68).

Were Taught in School About AIDS or HIV Infection

Nationwide, 89.5% of students had ever been taught in school about acquired immunodeficiency syndrome
(AIDS) or human immunodeficiency virus (HIV) infection
(Table 67). Overall, the prevalence of having been taught in
school about AIDS or HIV infection was higher among female (90.2%) than male (88.7%) students. Overall, the prevalence
of having been taught in school about AIDS or HIV infection was higher among white (91.1%) and black (90.3%)
than Hispanic (85.0%) students; higher among white female (91.7%) and black female (91.8%) than
Hispanic female (84.8%) students; and higher among white male (90.5%) and black male (88.8%) than Hispanic male
(85.1%) students. Overall, the prevalence of having been taught in school about AIDS or HIV infection was higher among
10th-grade (89.7%), 11th-grade (91.8%), and 12th-grade (90.0%) than 9th-grade (87.1%) students; higher among
11th-grade (91.8%) than 12th-grade (90.0%) students; higher among 11th-grade female (92.6%) and 12th-grade
female (90.9%) than 9th-grade female (87.7%) students; and higher among 10th-grade male (89.2%) and 11th-grade
male (91.0%) than 9th-grade male (86.4%) students. Prevalence of having been taught in school about AIDS or
HIV infection ranged from 79.0% to 91.7% across state surveys (median: 87.5%) and from 76.7% to 92.3% across
local surveys (median: 85.6%) (Table 68).

Dietary Behaviors

Ate Fruits and Vegetables Five or More Times per Day

Nationwide, 21.4% of students had eaten fruits and
vegetables§§ five or more times per day during the 7
days before the survey (Table 70). Overall, the prevalence of having eaten fruits and vegetables five or more times per day
was higher among male (22.9%) than female (19.9%) students; higher among white male (20.1%) than
white female (17.6%) students; and higher among 9th-grade male (25.4%) and 11th-grade male (22.6%) than
9th-grade female (22.0%) and 11th-grade female (17.2%) students, respectively. Overall, the prevalence of having eaten fruits
and vegetables five or more times per day was higher among black (24.9%) and Hispanic (24.0%) than white
(18.8%) students; higher among black female (23.4%) and Hispanic female (22.1%) than white female (17.6%) students;
and higher among black male (26.6%) and Hispanic male (25.9%) than white male (20.1%) students. Overall,
the prevalence of having eaten fruits and vegetables five or more times per day was higher among 9th-grade (23.7%)
and 10th-grade (22.4%) than 11th-grade (19.9%) and 12th-grade (18.6%) students; higher among 9th-grade
female (22.0%) than 11th-grade female (17.2%) and 12th-grade female (18.3%) students; higher among 10th-grade
female (21.6%) than 11th-grade female (17.2%) students; and higher among 9th-grade male (25.4%) than 12th-grade
male (19.0%) students. Prevalence of having
eatenfruits and vegetables five or more times per day ranged from 13.2%
to 23.8% across state surveys (median: 17.9%) and from 16.9% to 28.8% across local surveys (median: 20.9%)
(Table 71).

Drank Three or More Glasses per Day of Milk

Nationwide, 14.1% of students had drunk three or more glasses per day of milk during the 7 days before the
survey (Table 70). Overall, the prevalence of having drunk three or more glasses per day of milk was higher among
male (19.4%) than female (8.8%) students; higher among white male (22.2%), black male (13.6%), and Hispanic
male (17.3%) than white female (9.9%), black female (5.7%), and Hispanic female (8.1%) students, respectively; and
higher among 9th-grade male (19.0%), 10th-grade male (20.7%), 11th-grade male (19.4%), and 12th-grade male
(18.4%) than 9th-grade female (10.2%), 10th-grade female
(9.3%), 11th-grade female (7.6%), and 12th-grade female
(7.9%) students, respectively. Overall, the prevalence of having drunk three or more glasses per day of milk was higher
among white (16.1%) than black (9.7%) and Hispanic (12.7%) students; higher among Hispanic (12.7%) than black
(9.7%) students; higher among white female (9.9%) and Hispanic female (8.1%) than black
female (5.7%) students; higher among white male (22.2%) than black male (13.6%) and Hispanic male (17.3%) students; and higher among
Hispanic male (17.3%) than black male (13.6%) students. The prevalence of having drunk three or more glasses per day of
milk was higher among 9th-grade female (10.2%) than 11th-grade female (7.6%) students. Prevalence of having drunk
three or more glasses per day of milk ranged from 8.0% to 25.4% across state surveys (median: 14.5%) and from 5.1%
to 14.2% across local surveys (median: 8.8%) (Table 71).

Drank Soda or Pop at Least One Time per Day

Nationwide, 33.8% of students had drunk a can, bottle, or glass of soda or pop (not including diet soda or diet
pop) at least one time per day during the 7 days before the survey (Table 72). Overall, the prevalence of having drunk soda
or pop at least one time per day was higher among male (38.6%) than female (29.0%) students; higher among white
male (40.6%) and Hispanic male (37.3%) than white female (27.3%) and Hispanic female (29.5%) students,
respectively; and higher among 9th-grade male (39.5%), 10th-grade male (36.6%), 11th-grade male (39.0%), and 12th-grade
male (39.2%) than 9th-grade female (31.5%), 10th-grade female (29.8%), 11th-grade female (26.5%), and
12th-grade female (27.2%) students, respectively. Overall, the prevalence of having drunk soda or pop at least one time per day
was higher among higher among black (37.6%) than Hispanic (33.4%) students; and higher among black female
(37.2%) than white female (27.3%) and Hispanic female (29.5%) students. The prevalence of having drunk soda or pop at
least one time per day was higher among 9th-grade female (31.5%) than 11th-grade female (26.5%) students. Prevalence
of having drunk soda or pop at least one time per day ranged from 16.9% to 47.0% across state surveys (median:
29.5%) and from 14.4% to 39.9% across local surveys (median: 28.6%) (Table 73).

Physical Activity

Met Recommended Levels of Physical Activity

Nationwide, 34.7% of students had been physically
active doing any kind of physical activity that increased
their heart rate and made them breathe hard some of the time for a total of at least 60 minutes per day on 5 or more
days during the 7 days before the survey (i.e., met recommended levels of physical activity)
(14) (Table 74). Overall, the prevalence of having met recommended levels of physical activity was higher among male (43.7%) than
female (25.6%) students; higher among white male (46.1%), black male (41.3%), and Hispanic male (38.6%) than white
female (27.9%), black female (21.0%), and Hispanic female (21.9%) students, respectively; and higher among 9th-grade
male (44.4%), 10th-grade male (45.1%), 11th-grade male (45.2%), and 12th-grade male (38.7%) than 9th-grade
female (31.5%), 10th-grade female (24.4%), 11th-grade female (24.6%), and 12th-grade
female (20.6%) students, respectively. Overall, the prevalence of having met recommended levels of physical activity was higher among
white (37.0%) than black (31.1%) and Hispanic (30.2%) students; higher among white
female (27.9%) than black female (21.0%) and Hispanic female (21.9%) students; and higher among white male (46.1%) than black male (41.3%)
and Hispanic male (38.6%) students. Overall, the prevalence of having met recommended levels of physical activity
was higher among 9th-grade (38.1%) than 10th-grade (34.8%), 11th-grade (34.8%), and 12th-grade (29.5%)
students; higher among 10th-grade (34.8%) and 11th-grade (34.8%) than 12th-grade (29.5%) students; higher among
9th-grade female (31.5%) than 10th-grade female (24.4%), 11th-grade
female (24.6%), and 12th-grade female (20.6%) students; and higher among 9th-grade male (44.4%), 10th-grade male (45.1%), and 11th-grade male (45.2%)
than
among 12th-grade male (38.7%) students. Prevalence of having met recommended levels of physical activity
ranged from 30.6% to 49.9% across state surveys (median: 43.6%) and from 28.1% to 48.5% across local surveys
(median: 33.6%) (Table 75).

Did Not Participate in 60 or More Minutes of Physical Activity on Any Day

Nationwide, 24.9% of students did not participate in 60 or more minutes of any kind of physical activity
that increased their heart rate and made them breathe hard some of the time on at least 1 day during the 7 days before
the survey (i.e., did not participate in 60 or more minutes of physical activity on any day) (Table 74). Overall,
the prevalence of not participating in 60 or more minutes of physical activity on any day was higher among female
(31.8%) than male (18.0%) students; higher among white female (28.2%), black female (42.1%), and Hispanic female
(35.2%) than white male (16.7%), black male (21.8%), and Hispanic male (18.8%) students, respectively; and higher
among 9th-grade female (26.1%), 10th-grade female (31.7%), 11th-grade female (34.3%), and 12th-grade female
(36.2%) than 9th-grade male (17.1%), 10th-grade male (16.3%), 11th-grade male (18.0%), and 12th-grade male
(21.5%) students, respectively. Overall, the prevalence of not participating in 60 or more minutes of physical activity on any
day was higher among black (32.0%) and Hispanic (27.1%) than white (22.4%) students; higher among black
(32.0%) than Hispanic (27.1%) students; higher among black female (42.1%) and Hispanic female (35.2%) than white
female (28.2%) students; higher among black female (42.1%) than Hispanic female (35.2%) students; and higher
among black male (21.8%) than white male (16.7%) students. Overall, the prevalence of not participating in 60 or
more minutes of physical activity on any day was higher among 11th-grade (26.2%) and 12th-grade (28.9%) than
9th-grade (21.5%) students; higher among 12th-grade (28.9%) than 10th-grade (24.0%) students; higher among
10th-grade female (31.7%), 11th-grade female (34.3%), and 12th-grade female (36.2%) than 9th-grade female (26.1%)
students; and higher among 12th-grade male (21.5%) than 9th-grade male (17.1%) and 10th-grade male (16.3%)
students. Prevalence of not participating in 60 or more minutes of physical activity on any day ranged from 10.5% to
26.7% across state surveys (median: 15.9%) and from 14.4% to 32.7% across local surveys (median: 22.6%) (Table 75).

Used Computers 3 or More Hours per Day

Nationwide, 24.9% of students played video or computer games or used a computer for something that was
not school work for 3 or more hours per day on an average school day (i.e., used computers 3 or more hours per day)
(Table 76). Overall, the prevalence of using computers 3 or more hours per day was higher among male (29.1%) than
female (20.6%) students; higher among white male (26.9%), black male (34.0%), and Hispanic male (30.7%) than
white female (18.2%), black female (26.7%), and Hispanic female (21.8%) students, respectively; and higher among
9th-grade male (30.5%), 10th-grade male (30.0%), 11th-grade male (29.5%), and 12th-grade male (25.6%) than
9th-grade female (24.9%), 10th-grade female (22.6%), 11th-grade female (17.9%), and 12th-grade
female (14.8%) students, respectively. Overall, the prevalence of using computers 3 or more hours per day was higher among
black (30.5%) and Hispanic (26.3%) than white (22.6%) students; higher among black (30.5%) than Hispanic
(26.3%) students; higher among black female (26.7%) than white female (18.2%) and Hispanic female (21.8%) students;
and higher among black male (34.0%) than white male (26.9%) students. Overall, the prevalence of using computers 3
or more hours per day was higher among 9th-grade (27.8%) than 11th-grade (23.7%) and 12th-grade (20.1%)
students; higher among 10th-grade (26.3%) and 11th-grade (23.7%) than 12th-grade (20.1%) students; higher among
9th-grade female (24.9%) and 10th-grade female (22.6%) than 11th-grade female (17.9%) and 12th-grade female
(14.8%) students; and higher among 9th-grade male (30.5%) and 11th-grade male (29.5%) than 12th-grade male
(25.6%) students. Prevalence of using computers 3 or more hours per day ranged from 12.5% to 31.1% across state
surveys (median: 22.7%) and from 20.2% to 38.3% across local surveys (median: 27.2%) (Table 77).

Watched Television 3 or More Hours per Day

Nationwide, 35.4% of students watched television 3 or more hours per day on an average school day (Table 76). Overall, the prevalence of having watched television 3 or more hours per day was higher among male (37.5%)
than female (33.2%) students; higher among white male (30.4%) than white female (24.0%) students; and higher
among 11th-grade male (35.4%) than 11th-grade female (29.6%) students. Overall, the prevalence of having
watched television 3 or more hours per day was higher among black (62.7%) and Hispanic (43.0%) than white
(27.2%)
students; higher among black (62.7%) than Hispanic (43.0%) students; higher among black female (60.6%)
and Hispanic female (43.6%) than white female (24.0%) students; higher among black female (60.6%) than
Hispanic female (43.6%) students; higher among black male (64.6%) and Hispanic male (42.4%) than white male
(30.4%) students; and higher among black male (64.6%) than Hispanic male (42.4%) students. Overall, the prevalence
of having watched television 3 or more hours per day was higher among 9th-grade (39.7%) and 10th-grade (37.0%)
than 11th-grade (32.5%) and 12th-grade (30.8%) students; higher among 9th-grade female (37.2%) and 10th-grade
female (35.9%) than 11th-grade female (29.6%) and 12th-grade female (28.9%) students; higher among 9th-grade
male (42.0%) than 11th-grade male (35.4%) and 12th-grade male (32.8%) students; and higher among 10th-grade
male (38.1%) than 12th-grade male (32.8%) students. Prevalence of having watched television 3 or more hours per
day ranged from 18.2% to 47.4% across state surveys (median: 29.8%) and from 33.2% to 60.5% across local
surveys (median: 45.3%) (Table 77).

Nationwide, 56.3% of students had played on at least one sports team (run by their school or community
groups) during the 12 months before the survey (Table 80). Overall, the prevalence of having played on at least one sports
team
was higher among male (62.1%) than female (50.4%) students; higher among white male (63.0%), black
male (65.1%), and Hispanic male (58.1%) than white female (54.8%), black female (44.7%), and Hispanic female
(41.8%) students, respectively; and higher among 9th-grade male (63.4%), 10th-grade male (64.7%), 11th-grade
male (63.0%), and 12th-grade male (56.2%) than 9th-grade female (54.7%), 10th-grade female (50.8%), 11th-grade
female (52.5%), and 12th-grade female (41.9%) students, respectively. Overall, the prevalence of having played on at least
one sports team was higher among white (58.9%) than Hispanic (50.0%) students; higher among white female
(54.8%) than black female (44.7%) and Hispanic female (41.8%) students; and higher among white male (63.0%) and
black male (65.1%) than Hispanic male (58.1%) students. Overall, the prevalence of having played on at least one
sports team was higher among 9th-grade (59.2%), 10th-grade (57.8%), and 11th-grade (57.7%) than 12th-grade
(49.0%) students; higher among 9th-grade female (54.7%), 10th-grade female (50.8%), and 11th-grade female (52.5%)
than 12th-grade female (41.9%) students; and higher among 9th-grade male (63.4%), 10th-grade male (64.7%), and
11th-grade male (63.0%) than 12th-grade male (56.2%) students. Prevalence of having played on at least one sports
team ranged from 46.0% to 67.1% across state surveys (median: 56.8%) and from 41.7% to 54.5% across local
surveys (median: 49.6%) (Table 81).

Injured While Exercising or Playing Sports

Among the 79.6% of students nationwide who exercised or played sports during the 30 days before the survey,
21.9% had had to see a doctor or nurse for an injury that happened while exercising or playing sports (Table 80). Overall,
the prevalence of having been injured while exercising or playing sports was higher among male (24.1%) than
female (19.3%) students; higher among white male (23.6%), black male (26.7%), and Hispanic male (24.7%) than
white female (19.9%), black female (19.3%), and Hispanic female (18.7%) students, respectively; and higher among
11th-grade male (23.8%) and 12th-grade male (20.9%) than 11th-grade female (18.2%) and 12th-grade female
(14.8%) students, respectively. Overall the prevalence of having been injured while exercising or playing sports was higher
among 9th-grade (24.0%), 10th-grade (22.8%), and 11th-grade (21.2%) than 12th-grade (18.1%) students; higher
among 9th-grade female (21.7%) and 10th-grade female (20.8%) than 12th-grade female (14.8%) students; and
higher among 9th-grade male (26.0%) than 12th-grade male (20.9%) students.

Nationwide, 15.8% of students were overweight (Table 82). The prevalence of overweight was higher among
white male (15.7%) and black female (21.4%) than white female (12.8%) and black male (16.6%) students,
respectively. Overall, the prevalence of overweight was higher among black (19.0%) and Hispanic (18.1%) than white
(14.3%) students and higher among black female (21.4%) and Hispanic female (17.9%) than white female (12.8%)
students. Overall, the prevalence of overweight was higher among 9th-grade (17.6%) than 12th-grade (14.0%) students
and higher among 9th-grade female (18.3%) than 10th-grade female (14.2%), 11th-grade female (14.2%), and
12th-grade
female (13.1%) students. Prevalence of overweight ranged from 11.4% to 18.2% across state surveys (median:
15.0%) and from 12.5% to 22.2% across local surveys (median: 17.7%) (Table 83).

Ate Less Food, Fewer Calories, or Low-Fat Foods to Lose Weight or to Keep From
Gaining Weight

During the 30 days before the survey, 40.6% of students nationwide had eaten less food, fewer calories, or
low-fat foods to lose weight or to keep from gaining weight
(Table 86). Overall, the prevalence of having eaten less food,
fewer calories, or low-fat foods to lose weight or to keep from gaining weight was higher among female (53.2%) than
male (28.3%) students; higher among white female (58.4%), black female (34.6%), and Hispanic female (52.0%)
than white male (28.3%), black male (21.0%), and Hispanic male (32.3%) students, respectively; and higher among
9th-grade female (50.5%), 10th-grade female (53.0%), 11th-grade female (54.0%), and 12th-grade female (56.4%)
than 9th-grade male (27.3%), 10th-grade male (29.1%), 11th-grade male (29.8%), and 12th-grade male (27.4%)
students, respectively. Overall, the prevalence of having eaten less food, fewer calories, or low-fat foods to lose weight or to
keep from gaining weight was higher among white (43.3%) and Hispanic (42.1%) than black (27.8%) students;
higher among white female (58.4%) than black female (34.6%) and Hispanic female (52.0%) students; higher
among Hispanic female (52.0%) than black female (34.6%) students; higher among white male (28.3%) than black
male (21.0%) students; and higher among Hispanic male (32.3%) than white male (28.3%) and black male
(21.0%) students. Overall, the prevalence of having eaten less food, fewer calories, or low-fat foods to lose weight or to keep
from gaining weight was higher among 12th-grade (42.0%) than 9th-grade (38.6%) students and higher among
12th-grade female (56.4%) than 9th-grade female (50.5%) students. Prevalence of having eaten less food, fewer calories, or
low-fat
foods to lose weight or to keep from gaining weight ranged from 35.1% to 43.7% across state surveys (median:
39.1%) and from 30.6% to 41.3% across local surveys (median: 35.9%) (Table 87).

Exercised to Lose Weight or to Keep From Gaining Weight

Nationwide, 60.9% of students had exercised to lose weight or to keep from gaining weight during the 30 days
before the survey (Table 86). Overall, the prevalence of having exercised to lose weight or to keep from gaining weight
was higher among female (67.0%) than male (55.0%) students; higher among white female (71.5%) and Hispanic
female (66.4%) than white male (53.3%) and Hispanic male (60.1%) students, respectively; and higher among
9th-grade female (70.6%), 10th-grade female (67.7%), 11th-grade female (65.0%), and 12th-grade
female (63.7%) than 9th-grade male (58.7%), 10th-grade male (54.2%), 11th-grade male (54.9%), and 12th-grade male (51.1%)
students, respectively. Overall, the prevalence of having exercised to lose weight or to keep from gaining weight was higher
among white (62.4%) and Hispanic (63.2%) than black (52.2%) students; higher among white female (71.5%) than
black female (50.7%) and Hispanic female (66.4%) students; higher among Hispanic female (66.4%) than black
female (50.7%) students; and higher among Hispanic male (60.1%) than white male (53.3%) and black male
(53.7%) students. Overall, the prevalence of having exercised to lose weight or to keep from gaining weight was higher
among 9th-grade (64.5%) than 10th-grade (60.9%), 11th-grade (59.9%), and 12th-grade (57.5%) students; higher
among 10th-grade (60.9%) than 12th-grade (57.5%) students; higher among 9th-grade female (70.6%) than
11th-grade female (65.0%) and 12th-grade female (63.7%) students; higher among 10th-grade female (67.7%) than
12th-grade female (63.7%) students; higher among 9th-grade male (58.7%) than 10th-grade male (54.2%) and 12th-grade
male (51.1%) students; and higher among 11th-grade male (54.9%) than 12th-grade male (51.1%) students. Prevalence
of having exercised to lose weight or to keep from gaining weight ranged from 56.8% to 65.4% across state
surveys (median: 61.1%) and from 50.5% to 69.3% across local surveys (median: 58.4%) (Table 87).

Did Not Eat for 24 or More Hours to Lose Weight or to Keep From Gaining Weight

Nationwide, 11.8% of students did not eat for 24 or more hours to lose weight or to keep from gaining weight
during the 30 days before the survey (Table 88). Overall, the prevalence of not eating for 24 or more hours to lose weight or
to keep from gaining weight was higher among female (16.3%) than male (7.3%) students; higher among white
female (16.7%), black female (13.2%), and Hispanic female (17.4%) than white male (5.7%), black male (7.4%),
and Hispanic male (10.7%) students, respectively; and higher among 9th-grade female (16.8%), 10th-grade
female (19.1%), 11th-grade female (14.8%), and 12th-grade female (13.6%) than 9th-grade male (6.5%), 10th-grade
male (6.5%), 11th-grade male (8.1%), and 12th-grade male (8.0%) students, respectively. Overall, the prevalence of
not eating for 24 or more hours to lose weight or to keep from gaining weight was higher among Hispanic (14.1%)
than white (11.2%) and black (10.3%) students; higher among white female (16.7%) and Hispanic female (17.4%)
than black female (13.2%) students; and higher among Hispanic male (10.7%) than white male (5.7%) students.
The prevalence of not eating for 24 or more hours to lose weight or to keep from gaining weight was higher among
9th-grade female (16.8%) than 12th-grade female (13.6%) students and higher among 10th-grade female (19.1%) than
11th-grade female (14.8%) and 12th-grade female (13.6%) students. Prevalence of not eating for 24 or more hours to
lose weight or to keep from gaining weight ranged from 9.7% to 14.3% across state surveys (median: 12.0%) and
from 8.9% to 14.0% across local surveys (median: 11.9%) (Table 89).

Took Diet Pills, Powders, or Liquids to Lose Weight or to Keep From Gaining Weight

During the 30 days before the survey, 5.9% of students nationwide had taken diet pills, powders, or liquids without
a doctor's advice to lose weight or to keep from gaining weight (Table 88). Overall, the prevalence of having taken
diet pills, powders, or liquids without a doctor's advice to lose weight or to keep from gaining weight was higher
among female (7.5%) than male (4.2%) students; higher among white female (8.3%) and Hispanic female (7.8%) than
white male (3.7%) and Hispanic male (5.1%) students, respectively; and higher among 9th-grade female (6.1%),
10th-grade female (6.9%), 11th-grade female (7.4%), and 12th-grade female (10.2%) than 9th-grade male (2.9%),
10th-grade male (3.8%), 11th-grade male (5.0%), and 12th-grade male (5.7%) students, respectively. Overall, the prevalence
of having taken diet pills, powders, or liquids without a doctor's advice to lose weight or to keep from gaining weight
was higher among white (6.0%) and Hispanic (6.4%) than black (3.7%) students and higher among white female
(8.3%)
and Hispanic female (7.8%) than black female (3.9%) students. Overall, the prevalence of having taken diet
pills, powders, or liquids without a doctor's advice to lose weight or to keep from gaining weight was higher among
11th-grade (6.2%) and 12th-grade (8.0%) than 9th-grade (4.4%) students; higher among 12th-grade (8.0%) than
10th-grade (5.3%) and 11th-grade (6.2%) students; higher among 12th-grade
female (10.2%) than 9th-grade female (6.1%), 10th-grade female (6.9%), and 11th-grade female (7.4%) students; and higher among 11th-grade male
(5.0%) and 12th-grade male (5.7%) than 9th-grade male (2.9%) students. The prevalence of having taken diet pills,
powders, or liquids without a doctor's advice to lose weight or to keep from gaining weight ranged from 3.9% to 8.6% across
state surveys (median: 6.7%) and from 3.3% to 10.3% across local surveys (median: 5.4%) (Table 89).

Vomited or Took Laxatives to Lose Weight or to Keep From Gaining Weight

Nationwide, 4.3% of students had vomited or taken laxatives to lose weight or to keep from gaining weight during
the 30 days before the survey (Table 90). Overall, the prevalence of having vomited or taken laxatives to lose weight or
to keep from gaining weight was higher among female (6.4%) than male (2.2%) students; higher among white
female (6.9%) and Hispanic female (7.0%) than white male (1.3%) and Hispanic male (3.7%) students, respectively;
and higher among 9th-grade female (5.5%), 10th-grade female (7.6%), 11th-grade female (5.7%), and 12th-grade
female (6.6%) than 9th-grade male (2.1%), 10th-grade male (1.8%), 11th-grade male (2.1%), and 12th-grade male
(2.6%) students, respectively. Overall, the prevalence of having vomited or taken laxatives to lose weight or to keep from
gaining weight was higher among Hispanic (5.3%) than black (3.0%) students; higher among white female (6.9%)
and Hispanic female (7.0%) than black female (3.5%) students; and higher among black male (2.5%) and Hispanic
male (3.7%) than white male (1.3%) students. Prevalence of having vomited or taken laxatives to lose weight or to keep
from gaining weight ranged from 3.6% to 7.9% across state surveys (median: 5.4%) and from 2.4% to 9.0% across
local surveys (median: 5.2%) (Table 91).

Other Health-Related Topics

Lifetime Asthma

Nationwide, 20.3% of students had ever been told by a doctor or nurse that they had asthma (i.e., lifetime
asthma) (Table 92). Overall, the prevalence of lifetime asthma was higher among black (24.0%) than white (19.6%)
and Hispanic (18.5%) students and higher among black male (24.6%) than white male (18.9%) and Hispanic
male (17.7%) students. Prevalence of lifetime asthma ranged from 15.4% to 28.7% across state surveys (median: 21.4%)
and from 15.1% to 27.9% across local surveys (median: 20.9%) (Table 93).

Current Asthma

Nationwide, 10.9% of students had lifetime asthma and still had asthma (i.e., current asthma) (Table 92).
Overall, the prevalence of current asthma was higher among female (12.5%) than male (9.3%) students; higher among
white female (12.2%) and Hispanic female (11.4%) than white male (8.8%) and Hispanic male (7.7%)
students, respectively; and higher among 10th-grade female (13.3%) and 11th-grade female (12.3%) than 10th-grade
male (9.5%) and 11th-grade male (8.3%) students, respectively. Overall, the prevalence of current asthma was higher
among black (14.7%) than white (10.5%) and Hispanic (9.5%) students; higher among black female (15.6%) than
white female (12.2%) and Hispanic female (11.4%) students; and higher among black male (13.6%) than white male
(8.8%) and Hispanic male (7.7%) students. The prevalence of current asthma was higher among 9th-grade male (10.9%)
than 11th-grade male (8.3%) and 12th-grade male (8.1%) students. Prevalence of current asthma ranged from 8.4%
to 14.2% across state surveys (median: 10.9%) and from 6.8% to 19.9% across local surveys (median: 9.4%) (Table 93).

Nationwide, 17.4% of students most of the time or
always stayed in the shade, wore long pants, wore a
long-sleeved shirt, or wore a hat that shaded their face, ears, and neck when outside for more than 1 hour on a sunny day
(i.e., routine practice of sun-safety behaviors) (Table 94). Overall, the prevalence of routine practice of sun-safety
behaviors was higher among male (19.4%) than female (15.4%) students; higher among white male (18.3%) and Hispanic
male (22.7%) than white female (11.4%) and Hispanic female (19.1%) students, respectively; and higher among
9th-grade male (21.0%), 11th-grade male (18.0%), and 12th-grade male (20.1%) than 9th-grade female (15.4%),
11th-grade female (14.8%), and 12th-grade female (14.8%) students, respectively. Overall, the prevalence of routine practice
of sun-safety behaviors was higher among black (21.1%) and Hispanic (20.9%) than white (14.9%) students;
higher among black female (23.3%) and Hispanic female (19.1%) than white female (11.4%) students; and higher
among Hispanic male (22.7%) than white male (18.3%) students.

Eight or More Hours of Sleep

Nationwide, 31.1% of students had 8 or more hours of sleep on an average school night (Table 95). Overall,
the prevalence of having had 8 or more hours of sleep was higher among male (33.4%) than female (28.7%)
students; higher among white male (34.2%) than white female (27.5%) students; and higher among 10th-grade male
(35.6%) and 11th-grade male (27.3%) than 10th-grade female (29.2%) and 11th-grade female (22.6%) students,
respectively. Overall, the prevalence of having had 8 or more hours of sleep was higher among Hispanic (34.4%) than black
(28.8%) students; higher among Hispanic female (33.4%) than white female (27.5%) students; and higher among white
male (34.2%) and Hispanic male (35.4%) than black male (28.0%) students. Overall, the prevalence of having had 8
or more hours of sleep was higher among 9th-grade (42.3%) than 10th-grade (32.4%), 11th-grade (24.9%), and
12th-grade (21.8%) students; higher among 10th-grade (32.4%) than 11th-grade (24.9%) and 12th-grade
(21.8%) students; higher among 9th-grade female (39.4%) than 10th-grade female (29.2%), 11th-grade female (22.6%),
and 12th-grade female (21.9%) students; higher among 10th-grade female (29.2%) than 11th-grade female (22.6%)
and 12th-grade female (21.9%) students; higher among 9th-grade male (45.0%) than 10th-grade male (35.6%),
11th-grade male (27.3%), and 12th-grade male (21.6%) students; higher among 10th-grade male (35.6%) than
11th-grade male (27.3%) and 12th-grade male (21.6%) students; and higher among 11th-grade male (27.3%) than
12th-grade male (21.6%) students.

Trends During 1991--2007

Behaviors that Contribute to Unintentional Injuries

During 1991--2007, a significant linear decrease occurred in the percentage of students who rarely or never wore
a seat belt (25.9%--11.1%), who rarely or never wore a
motorcycle helmet (42.9%--33.9%), and who rode with a
driver who had been drinking alcohol (39.9%--29.1%). The percentage of students who rarely or never wore a
bicycle helmet decreased during 1991--2001 (96.2%--84.7%) and then did not change significantly during 2001--2007
(84.7%--85.1%). The percentage of students who drove when they had been drinking alcohol did not change
significantly during 1991--1997 (16.7%--16.9%) and then decreased during 1997--2007 (16.9%--10.5%). During
2005--2007, no significant changes occurred in any of these variables.

Behaviors that Contribute to Violence

The percentage of students who carried a weapon
decreased during 1991--1999 (26.1%--17.3%) and then did
not change significantly during 1999--2007 (17.3%--18.0%); the percentage of students who carried a
gun
decreased during 1993--1999 (7.9%--4.9%) and then did not change significantly during 1999--2007
(4.9%--5.2%). The percentage of students who had been in a physical fight decreased during 1991--2003 (42.5%--33.0%) and
then increased during 2003--2007 (33.0%--35.5%). During 2005--2007, no significant changes occurred in any of
these behaviors that contribute to violence.

The percentage of students who carried a weapon on school property decreased during 1993--2003
(11.8%--6.1%) and then did not change significantly during 2003--2007 (6.1%--5.9%). The percentage of students who had been in
a physical fight on school property decreased during 1993--2001 (16.2%--12.5%) and then did not change
significantly during 2001--2007 (12.5%--12.4%). During 2003--2007, a significant linear decrease occurred in the percentage
of students who had property stolen or damaged on school property (29.8%--27.1%). The percentage of students who
had property stolen or damaged on school property also decreased during 2005--2007 (29.8%--27.1%). During
1993--2007, a significant linear increase occurred in the percentage of students who did not go to school because of
safety concerns (4.4%--5.5%).

During 1991--2007, a significant linear decrease occurred in the percentage of students who seriously
considered attempting suicide (29.0%--14.5%) and in the percentage of students who made a suicide plan (18.6%--11.3%).
The percentage of students who attempted suicide did not change significantly during 1991--2001 (7.3%--8.8%) and
then decreased during 2001--2007 (8.8%--6.9%). The percentage of students who made a suicide attempt that had to
be treated by a doctor or nurse did not change significantly during 1991-- 2003 (1.7%--2.9%) and then decreased
during 2003--2007 (2.9%--2.0%). During 2005--2007, significant decreases also occurred in the percentage of students
who seriously considered attempting suicide (16.9%--14.5%), who made a suicide plan (13.0%--11.3%), and
who attempted suicide (8.4%--6.9%).

Tobacco Use

The percentage of students who reported lifetime cigarette use did not change significantly during
1991--1999 (70.1%--70.4%) and then decreased during 1999--2007 (70.4%--50.3%). During 2001--2007, significant
linear decreases occurred in the percentage of students who
reported lifetime daily cigarette use (20.0%--12.4%),
who reported trying to quit smoking cigarettes (57.4%--49.7%), and who reported buying cigarettes in a store or gas
station (19.0%--16.0%). The percentage of students who reported trying to quit smoking cigarettes also decreased from
2005--2007 (54.6%--49.7%). The percentage of students who reported current cigarette use increased during
1991--1997 (27.5%--36.4%) and then decreased during 1997--2007 (36.4%--20.0%), and the percentage of students
who reported current frequent cigarette use increased during 1991--1999 (12.7%--16.8%) and then decreased during
1999--2007 (16.8%--8.1%). During 1991--2007, a significant linear decrease occurred in the percentage of students
who reported smoking more than 10 cigarettes per day (18.0%--10.7%). The percentage of students who
reported current smokeless tobacco use decreased during 1995--2003 (11.4%--6.7%) and then did not change significantly
during 2003--2007 (6.7%--7.9%). The percentage of students who reported current cigar use decreased during
1997--2005 (22.0%--14.0%) and then did not change significantly during 2005--2007 (14.0%--13.6%). During 1997--2007,
a significant linear decrease occurred in the percentage of students who reported current tobacco use (43.4%--25.7%).

Alcohol and Other Drug Use

During 1991--2007, a significant linear decrease occurred in the percentage of students who reported lifetime
alcohol use (81.6%--75.0%). The percentage of students who reported current alcohol use did not change significantly
during 1991--1999 (50.8%--50.0%) and then decreased during 1999--2007 (50.0%--44.7%), and the percentage of
students who reported episodic heavy drinking did not change significantly during 1991--1997 (31.3%--33.4%) and
then decreased during 1997--2007 (33.4%--26.0%). The percentage of students who reported lifetime marijuana
use increased during 1991--1999 (31.3%--47.2%) and then decreased during 1999--2007 (47.2%--38.1%), and
the percentage of students who reported current marijuana use increased during 1991--1999 (14.7%--26.7%) and
then decreased during 1999--2007 (26.7%--19.7%). The percentage of students who reported lifetime cocaine use
increased during 1991--1999 (5.9%--9.5%) and then decreased during 1999--2007 (9.5%--7.2%), and the percentage
of students who reported current cocaine use increased
during 1991--2001 (1.7%--4.2%) and then decreased
during 2001--2007 (4.2%--3.3%). The percentage of students who reported lifetime inhalant use decreased during
1995--2003 (20.3%--12.1%) and then did not change significantly during 2003--2007 (12.1%--13.3%). The percentage
of
students who reported lifetime illegal steroid use increased during 1991--2003 (2.7%--6.1%) and then
decreased during 2003--2007 (6.1%--3.9%). During 2001--2007, a significant linear decrease occurred in the percentage
of students who reported lifetime hallucinogenic drug use (13.3%--7.8%) and lifetime ecstasy use (11.1%--5.8%).
The percentage of students who reported lifetime heroine use did not change significantly during 1999--2003
(2.4%--3.3%) and then decreased during 2003--2007 (3.3%--2.3%). The percentage of students who reported
lifetime methamphetamine use did not change significantly during 1999--2001 (9.1%--9.8%) and then decreased
during 2001--2007 (9.8%--4.4%). The percentage of students who reported lifetime methamphetamine use also
decreased during 2005--2007 (6.2%--4.4%).

Age of Initiation of Risk Behaviors

The percentage of students who reported smoking a whole cigarette for the first time before age 13 years
increased during 1991--1993 (23.8%--26.9%) and then decreased during 1993--2007 (26.9%--14.2%). The percentage
of students who reported having drunk alcohol for the first time before age 13 years did not change significantly
1991--1999 (32.7%--32.2%) and then decreased during 1999--2007 (32.2%--23.8%). The percentage of students
who reported having tried marijuana for the first time before age 13 years increased during 1991--1999 (7.4%--11.3%)
and then decreased during 1999--2007 (11.3%--8.3%). During 2005--2007, no significant changes occurred in any
of these age of initiation variables.

Tobacco, Alcohol, and Other Drug Use on School Property

The percentage of students who smoked cigarettes on school property did not change significantly during
1993--1995 (13.2%--16.0%) and then decreased during 1995--2007 (16.0%--5.7%). During 1993--2007, a significant
linear decrease occurred in the percentage of students who drank alcohol on school property (5.2%--4.1%). The percentage
of students who used marijuana on school property increased during 1993--1995 (5.6%--8.8%) and then
decreased during 1995--2007 (8.8%--4.5%). The percentage of students who were offered, sold, or given an illegal drug on
school property increased during 1993--1995 (24.0%--32.1%) and then decreased during 1995--2007 (32.1%--22.3%).
The percentage of students who were offered, sold, or given an illegal drug on school property also decreased during
2005--2007 (25.4%--22.3%).

During 1991--2007, significant linear decreases occurred in the percentage of students who ever had
sexual intercourse (54.1%--47.8%), who had sexual intercourse with four or more persons during their lifetime
(18.7%--14.9%), and who were currently sexually active (37.5%--35.0%). The percentage of students who had
sexual intercourse for the first time before age 13 years decreased during 1991--2005 (10.2%--6.2%) and then did not
change significantly during 2005--2007 (6.2%--7.1%). The percentage of sexually active students who used a condom at
last sexual intercourse increased during 1991--2003 (46.2%--63.0%) and then did not change significantly during
2003--2007 (63.0%--61.5%). The percentage of students who drank
alcohol or used drugs before last sexual
intercourse increased during 1991--2001 (21.6--25.6) and then decreased during 2001--2007 (25.6%--22.5%). The percentage
of students who were taught in school about AIDS or HIV infection increased during 1991--1997 (83.3%--91.5%)
and then decreased during 1997--2007 (91.5%--89.5%). During 2005--2007, no significant changes occurred in any
of these sexual behavior variables.

Dietary Behaviors

During 1999--2007, significant linear decreases occurred in the percentage of students who ate fruits and
vegetables five or more times per day (23.9%--21.4%) and who drank three or more glasses per day of milk
(18.0%--14.1%). During 2005--2007, no significant changes occurred in either of these dietary behavior variables.

Physical Activity

No significant linear change occurred in the percentage of students who used computers 3 or more hours per
day during 2003--2007 (22.1%--24.9%). The percentage of students who used computers 3 or more hours per
day
increased during 2005--2007 (21.1%--24.9%). During 1999--2007, a significant linear decrease occurred in
the percentage of students who watched 3 or more hours per day of television (42.8%--35.4%). The percentage of
students who attended PE classes daily decreased during 1991--1995 (41.6%--25.4%) and then did not change
significantly during 1995--2007 (25.4%--30.3%).

Obesity, Overweight, and Weight Control

During 1999--2007, significant linear increases occurred in the percentage of students who were obese
(10.7%--13.0%) and who were overweight (14.4%--15.8%). The percentage of students who described themselves as
overweight decreased during 1991--1997 (31.8%--27.3%) and then increased during 1997--2007 (27.3%--29.3%).
The percentage of students who described themselves as overweight also decreased during 2005--2007
(31.5%--29.3%). During 1991--2007, a significant linear increase occurred in the percentage of students who were trying to lose
weight (41.8%--45.2%). During 1995--2007, a significant linear increase occurred in the percentage of students who
exercised to lose weight or to keep from gaining weight (51.0%--60.9%). The percentage of students who ate less food,
fewer calories, or low-fat foods to lose weight or to keep from gaining weight increased during 1999--2001
(40.4%--43.8%) and then decreased during 2001--2007 (43.8%--40.6%). The percentage of students who took diet pills, powders,
or liquids to lose weight or to keep from gaining weight increased during 1999--2001 (7.6%--9.2%) and then
decreased during 2001--2007 (9.2%--5.9%). The percentage of students who vomited or took laxatives to lose weight or to
keep from gaining weight did not change significantly during 1995--2003 (4.8%--6.0%) and then decreased during
2003--2007 (6.0%--4.3%).

Discussion

Certain risk behaviors are more likely to occur among subpopulations of students defined by sex, race/ethnicity,
and grade. However, this analysis could not isolate the
effects of sex, race/ethnicity, or grade from the effects of
socioeconomic status (SES) or culture on risk behaviors with substantial disparities. In a 1992 national study, after controlling for
age, sex, race/ethnicity, and school enrollment status (i.e., in school or out of school), adolescents aged 12--17 years were
less likely to report selected risk behaviors (e.g., smoking, physical inactivity, eating too little fruit and vegetables,
and episodic heavy drinking) as the SES (education or family income) of the responsible adult in their family increased
(15). Additional research is needed to assess the effect of specific educational, socioeconomic, cultural, and racial/ethnic
factors on the prevalence of health-risk behaviors among high school students.

For the majority of risk behaviors, prevalence does not vary substantially across states or across cities. However,
across state surveys, a range of 25 or more percentage points or a fivefold variation or greater was identified for
the following risk behaviors:

smoked more than 10 cigarettes per day (minimum: 1.9%; maximum: 12.8%);

bought cigarettes in a store or gas station
(minimum: 10.2%; maximum: 39.4%);

current smokeless tobacco use (minimum: 1.0%; maximum: 7.2%);

lifetime marijuana use (minimum: 22.8%;
maximum: 50.8%);

lifetime cocaine use (minimum: 0.9%; maximum: 12.6%);

current cocaine use (minimum: 0.5%; maximum: 6.2%);

lifetime illegal injection-drug use (minimum: 0.5%; maximum: 5.5%);

lifetime heroin use (minimum: 0.6%; maximum: 5.4%);

lifetime methamphetamine use (minimum: 0.7%; maximum: 9.0%);

used smokeless tobacco on school property
(minimum: 0.5%; maximum: 3.8%);

offered, sold, or given an illegal drug on school
property (minimum: 13.5%; maximum: 39.2%);

ever had sexual intercourse (minimum: 26.4%; maximum: 67.1%);

currently sexually active (minimum: 17.5%;
maximum: 49.7%);

drank soda or pop at least one time per day
(minimum: 14.4%; maximum: 39.9%);

watched television 3 or more hours per day
(minimum: 33.2%; maximum: 60.5%);

attended PE class (minimum: 29.3%; maximum: 78.9%); and

attended PE class daily (minimum: 6.5%;
maximum: 54.0%).

These variations might occur, in part, because of differences in state and local laws and policies, enforcement
practices, access to illegal drugs, availability of effective school and community interventions, prevailing behavioral and
social norms, demographic characteristics of the population, and adult practices. Longitudinal research is needed to
better understand the effect of these factors on the
development and prevalence of risk behaviors.

Healthy People 2010

The national YRBS is the primary source of data to measure 15
Healthy People 2010 objectives and three
leading health indicators (16). The Healthy People
2010 objectives provide a comprehensive agenda for improving the health
of all persons in the United States during the first decade of the 21st century. This report provides the 2010 target
and data from the 2007 national YRBS for all 15 objectives (Table 96).

Limitations

The findings in this report are subject to at least three limitations. First, these data apply only to youth
who attend school and, therefore, are not representative of all persons in this age group. Nationwide, in 2005, of
persons aged 16--17 years, approximately 3% were not enrolled in a high school program and had not completed high
school (17). Second, the extent of underreporting or overreporting of behaviors cannot be determined, although the
survey questions demonstrate good test-retest reliability
(8). Third, BMI is calculated on the basis of self-reported height
and weight, and, therefore, tends to underestimate the prevalence of obesity and overweight
(18).

Conclusion

The national YRBS data are used routinely by CDC and other federal agencies. For example, CDC uses YRBS data
for the following:

to assess trends in priority health-risk behaviors among high school students;

to evaluate components of CDC's Performance Plan in compliance with the Government Performance and
Results Act (19); and

to evaluate the contribution of HIV prevention and chronic disease prevention efforts in schools toward helping
the nation reduce health-risk behaviors among youth.

State and local agencies and nongovernmental organizations use YRBS data to set school health and health
promotion program goals, support modification of school health curricula or other programs, support new legislation and
policies that promote health, and seek funding for new initiatives. For example, Hillsborough County, Florida, used YRBS
data to enhance health education, physical education, and health science education programs and to create a guide for
high school science teachers to use when discussing specific topics related to HIV, STDs, and unintended pregnancies.
In Michigan, YRBS data are used to plan and advocate for coordinated school health programs and other
health-related initiatives in their state. The San Francisco Unified School District (SFUSD) developed the SFUSD Family Guide,
which combines its YRBS data in an easy-to-read form with information on related school health programs, national
research, and strategies for promoting health at home. The family guides are available to parents, students, and
community organizations. In Utah, YRBS data on sedentary activities were used in developing the "Unplug and Play Program"
to promote physical activity. This program was implemented for the first time in 2007.

Seventy six percent of all states have YRBS data representative of their high school students attending public
schools. Continued support for and expansion of YRBSS will help monitor and ensure effectiveness of public health and
school health programs for youth.

References

CDC, NCHS. Public use data file and documentation: multiple cause of death for ICD-10 2005 data [CD-ROM]. 2008.

US Department of Education, National Center for Education Statistics. Common Core of Data Public Elementary/Secondary School
Universe Survey. Washington, DC: US Department of Education, National Center for Education Statistics. Available at
http://nces.ed.gov/ccd.

US Department of Health and Human Services and US Department of Agriculture. Dietary guidelines for Americans 2005. Washington, DC:
US Department of Health and Human Services; 2005. Available at
http://www.healthierus.gov/dietaryguidelines.

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